Type Ⅳ cardiorenal syndrome, with lesions involving the heart and kidney, has a long and costly treatment time and a high mortality rate. Modern studies have shown that the development of cardiorenal syndrome-4 (CRS4) is associated with a variety of pathological mechanisms, and the role of oxidative stress in the heart, kidneys, and other systems has received widespread attention, so it is of great significance to study the mechanism of CRS4 oxidative stress. The mechanism of action of oxidative stress-regulated CRS type 4 is related to signaling pathways such as Nrf2, NF-κB, JAK/STAT3, and JNK, which prevent endothelial dysfunction by reducing inflammatory responses, inhibiting cardiac and renal oxidative stress, and preventing endothelial dysfunction by decreasing left ventricular hypertrophy and cardiorenal fibers. Studies have confirmed that some active ingredients and compound formulas of traditional Chinese medicine Possesses antioxidant effects, which can inhibit the occurrence of oxidative stress in cardiorenal syndrome type Ⅳ by reducing the formation of reactive oxygen species(ROS) and regulating the oxidative stress pathway, thus playing a role in preventing and controlling CRS4. However, there is a lack of systematic collation and generalization in this field. Therefore, relevant literature was reviewed, and the mechanism of action by which traditional Chinese medicine regulates oxidative stress to prevent and treat CRS4 was analyzed and elucidated, aiming to provide new insights for clinical research and drug development.