The production of bioactive compounds from traditional Chinese medicine and medicinal plants mainly depends on the extraction and separation from medicinal materials, which is time-consuming, laborious, and requires large amounts of medicinal resources. As the market demand for bioactive compounds increases, the shortage of medicinal resources tops the list. For a stable and sustainable supply of affordable bioactive compounds, it is necessary to optimize chemosynthetic and biosynthetic pathways. Although some progress has been made in chemocatalysis and biosynthesis, there are drawbacks and bottlenecks in current approaches. We hold the opinion that the combination of chemosynthesis and biosynthesis will be the key direction to efficiently produce bioactive compounds. Chemo-enzymatic synthesis, a strategy that combines biosynthesis and chemosynthesis, is an alternative approach for the heterologous production of bioactive compounds. This paper reviews the recent advances in the chemo-enzymatic synthesis of bioactive compounds derived from traditional Chinese medicine and medicinal plants, highlights the potential application, and presents our perspectives for future research.