Objectives This study was conducted to evaluate the therapeutic effect of herbal medicine after total knee arthroplasty. Methods Key words such as total knee arthroplasty and herbal medicine were searched in 10 databases (Ovid-Medline, Ovid-EMBASE, Ovid-AMED, Cochrane Library, China National Knowledge Infrastructure [CNKI], National Digital Science Library [NDSL], Koreanstudies Information Service System [KISS], Oriental medicine Advanced Searching Integrated System [OASIS], KoreaMed, KMBASE), and only suitable randomized controlled trials (RCTs) were selected. Results 8 RCTs were finally selected, and herbal medicine showed positive results for pain relief and functional recovery after total knee arthroplasty. However, the analyzed 8 RCTs showed a high overall risk of bias. Conclusions In the future, RCTs with a higher level of evidence on the effect of herbal medicine after total knee arthroplasty need to be continuously conducted. (J Korean Med Rehabil 2021;31(4):35-47)