Chronic atrophic gastritis(CAG) is widely recognized as a precancerous condition for gastric cancer.Traditional Chinese medicine(TCM) offers significant advantages and distinctive features in treating CAG.This study explored the etiology and pathogenesis of CAG and proposed TCM treatment strategies based on syndrome differentiation that focused on addressing the root causes solely by Yangming，supplementing deficiencies and draining excesses，protecting the spleen and stomach，ascending and descending qi，regulating qi and blood，removing stasis and dredging collaterals，expelling pathogenic factors and removing toxin，moistening by sweet，plain，and cold drugs，and harmonizing and soothing the stomach.These strategies aim to enhance the clinical efficacy of TCM in treating CAG.