Coronary artery atherosclerotic heart disease(CHD) is a cardiovascular disease characterized by myocardial ischemia and hypoxia as its main pathological features.Current consensus on the micro-biological basis for the formation and development of CHD includes dysregulation of glucose and lipid metabolism，oxidative stress，endothelial injury，and coagulation system abnormalities.The p38 mitogen-activated protein kinase(p38MAPK) signaling pathway is closely related to mechanisms such as cell proliferation，differentiation，apoptosis，and processes involving growth，metabolism，and inflammation.It plays a role in improving endothelial injury，vascular smooth muscle cell proliferation，myocardial injury，platelet activation，and lipid metabolism.Traditional Chinese medicine(TCM) treats CHD by resolving phlegm，removing blood stasis，tonifying deficiency，unblocking stagnation，regulating qi and blood，and balancing the yin and yang of the organs.TCM can influence p38MAPK signaling pathways to treat CHD.With the development of pharmacological research in Chinese medicine，various Chinese herbal monomers and compound formulas have been confirmed to regulate the p38MAPK signaling pathway，lowering blood lipid levels，reducing foam cell formation，alleviating inflammatory response，modulating cell apoptosis，and improving myocardial ischemia，thus offering potential therapeutic effects for CHD.