Recurrent spontaneous miscarriage (RSM) is one of the most common and complicated medical conditions amongst pregnant women. In recent years miscarriage rates have been progressively increasing, due to women trying to conceive later in life and the higher risk of pregnancy loss from in vitro fertilisation (IVF) and intra-uterine insemination (IUI). Traditional Chinese medicine (TCM) is often able to treat and prevent RSM. In this article the aetiology and pathology of RSM are analysed from an integrated perspective of TCM and modern biomedicine, and a TCM treatment programme using acupuncture and Chinese herbal medicine is presented.