The gut microbiota serves as a crucial modulator of host immunity and plays a pivotal role in regulating airway inflammation, maintaining immune balance, and affecting the course of associated diseases through gut-lung axis interactions. Recent studies increasingly demonstrate that patients with chronic inflammatory airway diseases (CIAD) commonly exhibit gut dysbiosis. This imbalance in gut microbiota can promote pulmonary inflammation and airway remodeling by affecting the synthesis of short-chain fatty acids (SCFAs), impairing intestinal mucosal barrier integrity, and disrupting immune regulation. With increasing attention to the gut-lung axis, microbiota-targeted therapeutic strategies have attracted growing attention. Traditional Chinese medicine (TCM), characterized by its multi-component composition, multi-target approach, and holistic regulatory properties, holds unique advantages in restoring gut microbial balance for the treatment of CIAD. This paper systematically reviews the therapeutic potential of TCMs and their bioactive constituents in managing CIAD through gut microbiota modulation. By regulating gut microbial composition and stimulating the generation of SCFAs, TCMs exert anti-inflammatory, immunomodulatory, and gut barrier-protective effects. TCMs thus offer novel perspectives and promising therapeutic strategies for CIAD treatment.