Fermentation of Chinese herbal medicine is an essential processing technique. The application of probiotics in the fermentation of Chinese herbal medicine can improve the efficacy and reduce the toxic and side effects of Chinese herbal medicine, and can play a good role of Chinese herbal medicine in clinical treatment. As an important microorganism in the fermentation of Chinese herbal medicine, probiotics complement each other and further promote the modern application of Chinese herbal medicine fermentation. This article elaborated on the types of strains used for probiotic fermentation of Chinese herbal medicine, providing a detailed introduction to the biotransformation mechanism of Chinese herbal medicine fermentation, and discussed the characteristics of different fermentation processes and their effects on fermented products. Ultimately the advantages of fermenting Chinese herbal medicine were elucidated, providing a certain reference for researchers in the field of Chinese herbal medicine fermentation.