Polysaccharides are crucial bioactive components of traditional Chinese medicine(TCM). The bioavailability and health effects of traditional Chinese medicine(TCM) polysaccharides are fundamentally governed by the metabolism regulation of carbohydrate-active enzymes(CAZymes) within the human intestinal flora. This review systematically summarized the classification and functional distribution of CAZymes in intestinal flora, as well as the dynamic regulatory mechanisms by which their encoded polysaccharide utilization loci(PULs) recognize and degrade TCM polysaccharides. Through synergistic interactions between substrate-binding modules(CBMs) and catalytic domains, CAZymes precisely recognize glycosidic bond types and spatial conformations of polysaccharides and then convert these complex polysaccharides into oligosaccharides, short-chain fatty acids(SCFAs), and other metabolites. These metabolites subsequently influence host health via immune regulation, metabolic homeostasis, and intestinal barrier repair. Furthermore, the review proposed that future research should focus on elucidating three-dimensional structures of CAZymes-polysaccharide complexes, exploring cross-phylum cooperative metabolic mechanisms, and developing microbiota-directed TCM polysaccharide delivery systems. This work systematically elucidated the core mechanisms of gut CAZymes-mediated TCM polysaccharide metabolism, providing theoretical foundations for clarifying the pharmacodynamic material basis of TCM and advancing innovative drug development of TCM polysaccharides.