Mitochondria are important organelles in cells for energy production, and mitochondrial damage caused by various reasons is an important factor promoting disease progression. Mitochondrial damage involves structural damage and mitochondrial DNA damage, which are closely related to the occurrence and development of respiratory system diseases. In recent years, a large number of studies have confirmed the significant role of mitochondrial damage in the progression of respiratory system diseases, which may be an important target for the treatment of respiratory system diseases with traditional Chinese medicine (TCM). This article reviews the role of TCM in regulating mitochondrial damage for intervention in respiratory system diseases such as chronic obstructive pulmonary disease, lung cancer, pulmonary fibrosis, acute lung injury, asthma, and pneumonia, aiming to provide a basis for the study of the pathogenesis and drug action targets of respiratory system diseases.