Childhood tic disorders (TD) are complex neurodevelopmental disorders, with core pathological mechanisms closely linked to dopaminergic system dysfunction. In recent years, traditional Chinese medicine (TCM) has demonstrated advantages such as holistic regulation multi-target and multi-pathway intervention in the prevention and treatment of pediatric TD. The dopaminergic signaling pathway plays a pivotal role in the onset and progression of TD. By regulating the functions of dopamine D1/D2 receptors, the expression of dopamine transporter (DAT), the activity of dopamine-metabolizing enzymes, and synaptic plasticity, TCM can restore the homeostasis of neurotransmitters and thereby alleviate tic symptoms. Formulas such as Tianma Gouteng Decoction, Jianpi Zhidong Decoction, Ningdong Granules and Chaihu Plus Longgu Muli Decoction can participate in reconstructing the homeostasis of the dopaminergic system and relieve tics. Specifically, they act by balancing the function of D1/D2 receptors, modulating DAT expression, regulating the activity of dopamine-metabolizing enzymes such as COMT and MAO-B, as well as optimizing the expression of synaptic-related proteins and the function of neural circuits. This article reviews the mechanisms of active ingredients of Chinese medicinal herbs, TCM compound prescriptions and proprietary Chinese medicines in treating pediatric TD via regulating the dopaminergic signaling pathway, aiming to provide theoretical basis and research ideas for the prevention and treatment of TD with TCM.