Although observational studies are valuable sources of scientific evidence, they are prone to bias and confounding. This study aimed to assess the quality of observational studies in Traditional Persian medicine (TPM).A systematic search was conducted in national and international databases up to the end of 2022 to identify observational studies on TPM. The quality of articles was evaluated using the STROBE checklist and CARE guidelines.Out of the 192 articles identified, 109 met the eligible criteria for quality assessment. Cross-sectional and case-control studies had a mean STROBE score of 1.2±0.51 out of 2, with the introduction section scoring highest and the results and methods sections scoring lowest. The worst reported items in the method section involved sensitivity analyses, bias control, and management of missing data. Case reports and case series had a mean score of 1.4±0.55 out of 2, with the section on therapeutic interventions scoring the highest. Other sections like keywords, follow-up and outcomes, diagnostic assessment, patient perspective, and informed consent scored below one.Many reviewed articles did not adhere to the recommended formatting in the evaluation tools, making it challenging to assess their quality. Having said that, the quality of observational studies in the field of TPM is a point of concern.