Ischemic stroke is a common type of cerebrovascular disease and often leads to death or disability in the global aging population. Tight junction integrity is closely related to ischemic stroke. Excessive destruction of tight junctions and increased permeability of the blood-brain barrier after brain tissue ischemia aggravates the pathological progression of ischemic brain injury. A large number of studies have shown that traditional Chinese medicine can effectively repair the tight junctions between cerebral vascular endothelial cells after ischemic stroke, thereby reducing damage to the blood-brain barrier and promoting recovery after brain injury. This review elucidates the possible mechanisms of the active components of traditional Chinese medicine, including monomers and monomers their extracts, and other compounds, in improving the neurological damage of ischemic stroke by regulating tight junctions. Progress in the discovery of clinical uses of traditional Chinese medicine for ischemic stroke are reviewed, including the new target of cerebral apoplexy.