Alzheimer’s disease（AD）is a neurodegenerative disease characterized by progressive cognitive impairment，and its pathogenesis is very complex. In recent years，vascular abnormalities such as decreased cerebral blood flow and blood - brain barrier disruption have been found in the early stage of AD，suggesting that vascular factors play an important role in its pathogenesis. As a key structure of brain functional homeostasis，the dysfunction of the neurovascular unit（NVU），including neurons，endothelial cells， pericytes，astrocytes，microglia，and basement membrane，has been considered to be one of the common pathological bases of AD and vascular dementia. Its disorder can lead to cognitive impairment. Traditional Chinese medicine can intervene NVU function through multiple targets and pathways，improve the permeability of blood-brain barrier，reduce neuroinflammation and oxidative stress，and is expected to become an important means to treat AD. This article elaborates the research progress of NVU and its markers regulated by traditional Chinese medicine in the early diagnosis and treatment of AD.