The broad and multi-source nature of evidence in traditional Chinese medicine(TCM) and integrated TCM and Western medicine clinical guidelines highlights the importance of evidence classification and grading.TCM has its own unique characteristics when it comes to evidence，and the modern medical evidence grading system is not entirely suitable for evaluating TCM evidence.Over the years，numerous scholars in China have explored grading systems for the quality of TCM evidence and recommendation levels.Therefore，from the perspective of TCM/integrated TCM-Western medicine clinical guidelines，this article reviewed the multi-source evidence in TCM，the basis and evolution of evidence quality and recommendation grading，analyzed the unique features of TCM evidence grading，and proposed recommendations for integrating TCM-specific evidence with real-world research and intelligent grading systems，aiming to stimulate further discussion and reflection among researchers to promote the development of scientifically sound and rational guidelines.