Abstract: The traditional Chinese medicine (TCM) culture in upholding fundamental principles and breaking new ground is to uphold fundamental principles of its essence and the law of development, and break new ground of its vitality and better efficacy. The “Six adherences” of Xi Jinping Thought on Socialism with Chinese Characteristics for a New Era provides important theoretical guidance and practical direction for responding to the times, achieving breakthroughs, and promoting the innovative development of TCM while upholding its traditional principles. Specifically, the worldview of TCM culture in upholding fundamental principles and breaking new ground is mainly the historical view of TCM created by the people, the systematic view of universal connection, and the worldview that all people and things are interrelated. It’s values are mainly to adhere to the supremacy of the people and protect the people’s health, to inherit and develop TCM culture with self-confidence and self-reliance, and to maintain a global vision to promote building a community of health for mankind. Its methodological principles are mostly that we must maintain self-confidence and self-reliance to establish our own quality standard and independent development plans, adopt a problem-oriented approach to solve various problems restricting TCM culture in upholding fundamental principles and breaking new ground, and also apply systems concept to formulate development strategies, reform the governance system, excavate the unique advantages of TCM in diagnosis and treatment, so as to create a new situation of development.