Traditional Chinese medicine (TCM) is a system of therapies that has developedthrough empiricism for over 2100 years and has remained a popular alternative medicinein some Far East Asian populations..Studies in TCM suggest that there is an intimate connectionbetween pharmacology of TCM and regulating ATP homeostasis.In this review, current advances of TCM in manipulating ATP production and utilization, including regulatingcatabolism of large molecules, proton gradient,the electron transfer chain activity, ATPase activity, and altering structure mitochondria, and energy charge, are summarized.Finally, some issues related to ATP manipulation are addressed.