Ulcerative colitis (UC) has emerged as a prevalent disease in China, with Western medicine primarily focusing on symptom relief, immune regulation, mucosal healing promotion, and complication reduction. Treatment modalities include aminosalicylic acid, glucocorticoids, immunomodulators, antibiotics, and surgery for severe cases. However, recurrence rates post-treatment remain notably high. Traditional Chinese Medicine (TCM) offers a distinct approach to UC treatment, characterized by syndrome differentiation and multi-target therapy. TCM demonstrates unique advantages, particularly in anti-recurrence strategies. This paper provides an overview of UC treatment approaches, comparing Western medicine and TCM perspectives. By examining the efficacy and mechanisms of action of TCM interventions, we explore the potential of TCM in managing UC recurrence. Through an analysis of clinical evidence and theoretical frameworks, we elucidate the holistic approach of TCM, emphasizing its ability to address underlying imbalances and promote long-term health outcomes. Furthermore, we discuss the integration of TCM and Western medicine paradigms, highlighting the complementary nature of these approaches in optimizing UC management. By synthesizing insights from both disciplines, this paper aims to inform clinical practice and guide future research directions in the management of UC in China and beyond.