Nasal administration of traditional Chinese medicine (TCM) has a long history of application. With the gradual maturing of technology and pharmacological advances, nasal preparations of TCM have undergone significant changes. Nasal TCM formulations are used not only for treatment of pneumonia, asthma, sinusitis and allergic rhinitis but also Alzheimer’s disease and Parkinson’s disease, as antidepressants and antiepileptics, and in ischemia reperfusion. In this study, we reviewed the development and application of different nasal preparations of TCM from the aspects of nasal structure, origin, factors affecting absorption and common dosage forms, pharmacodynamics, pharmacokinetics and safety. In the near future, we expect that more nasal preparations of Chinese medicine with independent intellectual property rights will be marketed to meet the needs of clinical disease management.