Abstract: Traditional Chinese medicine (TCM) is a unique medical resource in China. As an important part of TCM, the quality and safety of Chinese medical herbs have been attracting wide attentions. In the procedure of pest control on Chinese medical herbs, pesticide residue issues caused by non-standard application were closely associated with the product quality as well as the export trade. This review summarized the current status of pesticide registration and residue limit standards in Chinese medical herbs. The impact of different processing technologies on pesticide residues in Chinese medical herbs was also reviewed. On this basis, the relevant problems of pesticide application and management on Chinese medical herbs were thoroughly discussed, and the measures were proposed to reduce the pollution of pesticide residues. The aims of this review were to clarify the changes of pesticide residues from harvest to consumption of Chinese medical herbs, therefore, to provide insightful ideas to strengthen the pesticide residue control, to reduce the risks of excessive residues, and to enhance the rational use and management of pesticides in Chinese medical herbs.