Objective To evaluate the clinical efffcacy of traditional Chinese medicine combined with red and blue light in the treatment of acne. Methods The PubMed, Cochrane Library, EBSCO, China National Knowledge Infrastructure (CNKI), Wanfang Database, China Biology Medicine disc (CBM) and other Chinese and foreign databases were searched by computer to collect randomized controlled trials (RCT) related to traditional Chinese medicine combined with red and blue light for acne. The search time was from the establishment of the database to August 2025. Two researchers independently conducted literature screening and data extraction. The Cochrane Collaboration tool was used for quality assessment, and RevMan 5.3 software was employed to conduct Meta-analysis on the outcome indicators. Results A total of 7 eligible RCTs were ffnally included, involving 833 patients, with 440 patients in the experimental group and 393 patients in the control group. The results of Meta-analysis showed that the total effective rate of traditional Chinese medicine combined with red and blue light in the treatment of acne was superior to that of traditional Chinese medicine alone or red and blue light alone [RR=1.17, 95%CI (1.04, 1.31), Z=2.66, P=0.008], and the cure rate was also higher than that of traditional Chinese medicine alone or red and blue light alone [RR=1.97, 95%CI (1.35, 2.85), Z=3.56, P=0.0004]. There was no statistically signiffcant difference in the incidence of adverse reactions between the two groups [RR=0.96, 95%CI (0.47, 1.95), Z=0.12, P=0.90]. Conclusion Traditional Chinese medicine combined with red and blue light can effectively improve the symptoms of acne patients with favorable clinical efffcacy. It is superior to traditional Chinese medicine alone or red and blue light alone in improving the total effective rate and cure rate, and thus serves as an effective therapeutic method for acne.