To observe the nature，location in zang-fu organs and pathological products of disease in patients with cancer-related fatigue (CRF) by syndrome differentiation of Traditional Chinese Medicine (TCM).It may help to further clarify the TCM pathogenesis of CRF and provide an important theoretical basis for the use of TCM in the prevention and treatment of CRF.Methods:A total of 191 patients with CRF were treated in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from March 2016 to June 2016.Demographic information，score of RPFS-CV and clinical data from four diagnostic methods were collected to assess the deficiency of zang-fu organs，location and pathological products of disease，and the correlation in deficiency of zang-fu organs and level of fatigue was analyzed.Result：The most frequent syndrome of CRF was deficiency of spleen-qi，accounting for 80.6% of all patients，followed by deficiency of kidney-qi (43.5%)，deficiency of lung-qi (34.6%)，stagnation of liver-qi (21.5%).The analysis of pathological products indicated that 53.4% of CRF patients developed phlegm，15.7% developed static-blood and 30.9% developed both of them.CRF patients with the syndromes of kidney-yang deficiency (P<0.001)，kidney-qi deficiency (P<0.001)，spleen-yang deficiency (P<0.05) and stagnation of liver-qi (P<0.05) were associated with a higher level of fatigue.Conclusion:The TCM syndromes of CRF patients were dominated by deficiency syndromes and presented with the appearance of intermingled deficiency and excess.The locations of disease mainly included spleen，kidney and were also related to liver and lung.The TCM pathogenesis of CRF was related to the deficiency of spleen-qi and kidney-essence，and the intermingled phlegm，blood-stasis.The principle of treatment is reinforcing deficiency，accompanied with eliminating pathogen.The TCM methods for CRF were reinforcing qi and strengthening spleen，reinforcing kidney and replenishing essence，softening and resolving hard mass.