Polycystic ovary syndrome(PCOS) is the most prevalent endocrine and metabolic disorder among women of reproductive age，with ovarian fibrosis representing one of its critical pathological features.Although the precise mechanisms underlying PCOS-related ovarian fibrosis remain unclear，accumulating evidence suggests that the transforming growth factor-β1/Smad(TGF-β1/Smad) signaling pathway plays a central role in this fibrotic process.In traditional Chinese medicine(TCM)，PCOS ovarian fibrosis clinically aligns with syndromes such as “abdominal masses”，“infertility”，and “amenorrhea”.TCM treatment of PCOS primarily focuses on kidney tonification，liver regulation，and spleen fortification，combined with phlegm resolution and blood stasis elimination.TCM compound formulas including naringin，paeoniflorin，rhamnoside，silymarin，Sanghuangporus Sanghuang polysaccharides，and dietary proanthocyanidins as well as TCM formulas such as Bushen Culuan Decoction，Jinlida Granules，Qutan Huayu Formula，and Shugan Bushen Quyu Formula ameliorate ovarian fibrosis in PCOS by modulating the TGF-β1/Smad signaling pathway.