Rheumatoid arthritis (RA) is an autoimmune disease with an early clinical manifestation of symmetric small joint pain, which gradually worsens and often involves multiple joints, ultimately result ing in arthritic deformities and loss of labor capacity. Molecular signaling pathways have been a focus of research regarding the prevention and treatment of RA, and the progression of RA has been shown to be closely related to various signaling pathways, including the Janus kinase-signal transducer and activator of transcription, mitogen-activated protein kinase, NOD-like receptor protein 3, Toll like receptor, Wnt, Notch, hypoxia-inducible factor 1-α and vascular endothelial growth factor, programmed death factor 1 and ligand 1, and phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin signaling pathways. Increasing recent studies have investigated the external treatment of RA using traditional Chinese medicines based on the above signaling pathways. In this paper, we review the relevant data and reports to explain the relationship between the above pathways and the pathogenesis and prevention of RA. We also summarize the research result regarding the modulation of these signaling pathways by external treatment with traditional Chinese medicines aimed at preventing and treating rheumatoid joints, with a view to providing a scientific basis for the clinical selection of these treatments.