<p>The inherent complexity and variability of Chinese Herbal Medicine (CHM) components necessitate the implementation of robust and holistic quality control strategies. Fingerprint technology has emerged as a critical tool for this purpose, systematically characterising CHM profiles. This review synthesises the current landscape of fingerprinting, critically evaluating diverse modalities including chemical (e.g., HPLC, GC–MS, FTIR, NMR), DNA, and physical fingerprints. A comprehensive analysis was conducted to elucidate the fundamental principles underpinning these systems, to discern their comparative strengths and weaknesses, and to ascertain their primary applications in the domains of authentication, quality assessment, and origin tracing. Despite the fact that fingerprinting has evolved into a fundamental discipline for CHM quality assurance, with a versatile arsenal of techniques at its disposal, significant challenges persist, notably concerning reproducibility, standardisation, and establishing a robust "spectrum-effect" correlation between chemical profiles and pharmacological efficacy. Moreover, the harmonisation of data across diverse platforms persists as a significant challenge. It is acknowledged that no singular technique can be considered universally superior; consequently, an integrated, multimodal approach is emphasised as being essential. In order to propel the field forward, this review puts forward a roadmap with three key pillars: the development of universal standards, the systematic research of spectrum-effect correlations integrated with multi-omics data, and the facilitation of clinical translation. The ultimate objective is to transition from descriptive quality assessment to predictive standards grounded in therapeutic efficacy, thereby enhancing the safety, effectiveness and global integration of CHM.</p>