Chronic fatigue syndrome(CFS) is a complex disease characterized by persistent fatigue and multiple physical and neuropsychiatric symptoms. Its pathogenesis is not fully understood, and current Western medical treatments are limited. External therapies of traditional Chinese medicine(such as acupuncture, moxibustion, massage, and cupping) have shown favorable effects in relieving fatigue, sleep disturbances, and emotional symptoms in CFS patients, with overall effectiveness rates exceeding 80%. These therapies may act by modulating inflammatory responses, regulating immune and neuroendocrine-metabolic functions, and enhancing mitochondrial activity. This review also discusses the limitations of current research and provides theoretical references for establishing standardized treatment protocols.