Background: Demand for traditional Chinese medicine (TCM) appears to be growing strongly, particularly in developed Western nations, alongside Western biomedicine. This trend is reflected in the Cochrane systematic reviews (CSRs): 109 reviews and protocols with a focus on Chinese herbal medicine or acupuncture have been published in The Cochrane Library. While there is no sign of a slowing in consumer demand for TCM, it poses challenges to produce reviews that are both rigorous and inclusive. The Cochrane Menstrual Disorders and Subfertility Group (MDSG) has established the following relevant mechanisms to address the demands and challenges. 1) Request on incorporating Chinese databases: the numbers of scientific research papers doubled in 2006 and TCM in particular is part of mainstream of healthcare system in China. It is the MSDG policy that at least one of the five commonly used Chinese biomedical databases must be searched. 2) Implementation of a checklist for assessing quality of trials before inclusion decision in a systematic review: a checklist based on findings from assessing the quality of Cochrane systematic reviews of TCM is made specifically for TCM trials. This is to assist review authors to screen trials to minimise bias. 3) Incorporation of TCM expertise in the editorial assessment: the fundamental differences between the two paradigms present a particular challenge; a review of TCM concerning little traditional practice and principles jeopardises quantity and standard of CSRs. Since 2002, a TCM expert has been engaged to facilitate the process of respecting traditional philosophies whilst the methodologies of Western biomedicine are adopted. Systematic reviews adhere to the principle that science is cumulative and aid decisions, exploring methods and strategies to address the challenges above contributes in producing good quality of CSRs in TCM.