Diarrhea is a common side effect associated with use of antibiotics (Ma et al., 2019). Antibiotic-associated diarrhea (AAD) can broadly be defined as otherwise unexplained diarrhea that occurs in association with the administration of antibiotics (Bartlett, 2002, Cai et al., 2018). Currently, as a Cochrane review has demonstrated, the incidence of AAD is about 18 % in patients treated with antibiotics (Goldenberg et al., 2017). The spectrum of AAD ranges from mild and self-limiting diarrhea, colitis, and pseudomembranous colitis to toxic megacolon and death (Goldenberg et al., 2017, McFarland et al., 2016). In recent years, an increasing incidence of AAD, coupled with the rising cost of treatment and hospital stays, have caused heightened concern in China (Shen et al., 2017). Many studies are, therefore, focusing on finding medicine for the prevention and treatment of AAD, such as probiotics (Blaabjerg et al., 2017, Gray et al., 2019, Hayes and Vargas, 2016). Apart from probiotics, Chinese herbal medicine also has a beneficial effect on AAD (Jiang and Wang, 2020). Shenlingbaizhusan (SLBZS), which was first documented in the ancient traditional Chinese medical pharmacopeia "Tai Ping Hui Min He Ji Ju Fang" in the Song dynasty, has been widely prescribed to treat diarrhea for about 900 years. The formula is composed of ten herbal medicines: ginseng radix (ren-shen), atractylodis macrocphalae rhizoma (bai-zhu), poria (fu-ling), glycyrrhizae praeparata cum melle radix et rhizoma (zhi-gan-cao), dioscoreae rhizoma (shan-yao), lablab album semen (bai-bian-dou), coicis semen (yi-yi-ren), amomi fructus (sha-ren), nelumbinis semen (lian-zi), and platycodonis radix (jie-geng) (Table 1). Most of the herbal medicines in SLBZS have shown effectiveness in the treatment of diarrhea (Mundy et al., 2016). Currently, SLBZS is used to treat AAD, and many trials have been reported in China on its effectiveness in preventing and treating AAD. Modern pharmacological studies have shown that SLBZS’ efficacy might be attributed to its ability to help re-establish an anti-inflammatory milieu and microbiome (Feng et al., 2022). SLBZS could address gut dysbiosis, enhance adaptive immunity in mesenteric lymph nodes, and support mucosal healing (Xia et al., 2019, Zhang et al., 2019). Also, SLBZS could modulate intestinal absorption function and dyspepsia and restore intestinal double-fold barrier function (Chen et al., 2022). SLBZS is a noteworthy option owing to its low cost as well as its preventive and therapeutic effects. Thus, to assess the safety and efficacy of SLBZS for antibiotic-associated diarrhea, a systematic review in this area was conducted.