Background Little is known about quality and quantity of traditional Chinese clinical guidelines. We aim to systematically review all of traditional Chinese clinical guidelines.

Methods We searched CNKI (China National Knowledge Infrastructure/Chinese Academic Journals full text Database), VIP (a fulltext database of China), WANFANG (a fulltext database of China) and CBM (China Biomedicine Database Disc). Two groups of review authors independently applied inclusion criteria, assessed trial quality, and extracted data.

Results We identified 75 traditional Chinese clinical guidelines from 2003 to 2012, and only 11(15%) were claimed that an evidence based approached were used in the process of development. From the assessment with the Appraisal of Guidelines for Research and Evaluation II (AGREE II), the mean scores were low for the domains ‘clarity of presentation’ (28%), ‘scope and purpose’ (15%) and ‘editorial independence’ 12%; and very low for the other domains (‘stakeholder involvement’ 8%, ‘rigour of development’ 5% and ‘applicability’ 3%). AGREE II mean scores of traditional Chinese clinical guidelines lower than Chinese clinical practice guidelines and the world average.

Conclusions Traditional Chinese clinical guidelines received lower scores, which indicate a relatively poor quality of the guidelines. However, there was some increase over time. Meanwhile, given the characteristics of Traditional Chinese medicine, CONSORT group has been developing CONSORT for TCM and for Acupuncture, we plan to develop AGREE TCM to be used to inform the development, appraisal and reporting of evidence-informed traditional Chinese clinical guidelines.