Malignant tumors are a common clinical disease with a high mortality rate，posing a serious threat to human life and health.Clinical and experimental studies have shown that traditional Chinese medicine(TCM) exhibits significant therapeutic effects in the treatment of malignant tumors.Original qi originates from ancient philosophical concepts and constitutes an essential part of TCM theory.Many TCM practitioners believe that “deficiency of original qi is the root cause of disease”，and abnormalities in the generation and transformation of original qi may lead to malignant tumors and other diseases.Therefore，this paper explores the TCM pathogenesis of malignant tumors based on original qi theory，proposing that abnormalities in the generation and transformation of original qi are a key pathogenic mechanism of malignant tumors.This may be associated with immune system dysfunction，metabolic imbalances，and biological mechanisms related to tumor progression，recurrence，and metastasis.Furthermore，the study suggests that the method of banking up original qi serves as an important therapeutic approach for malignant tumors，advocating an internal-external regulatory treatment strategy that replenishes deficiency while eliminating pathogenic factors.This approach aims to provide a reference for the differentiation and treatment of malignant tumors in TCM.