With the advancement of scale，intensification，and mechanization in agricultural production，the issue of continuous cropping obstacles for medicinal plants is increasingly conspicuous. In China’s traditional Chinese medicine resources，roots and rhizomes constitute a significant portion of authentic medicinal materials，and are widely employed in traditional Chinese medicine. Owing to their distinctive “authenticity，” continuous cropping obstacles have emerged as a pressing concern for root and rhizome authentic medicinal materials. This review elucidated the causes of continuous cropping obstacles and their corresponding alleviation measures，aiming to offer insights for mitigating continuous cropping challenges faced by root and rhizome authentic medicinal materials. The origins of continuous cropping issues for root and rhizome authentic medicinal materials were multifaceted，stemming from the interplay of various factors within the three systems of medicinal plants，soil，and microorganisms. These factors mainly included allelopathy，transformations in soil physicochemical properties，and fluctuations in soil microbial communities. The common measures to alleviate continuous cropping obstacles encompassed the cultivation of resilient new varieties，optimization of farming practices，soil sterilization，improving soil conditioners，and regulation of functional microorganisms. Moreover，the spotlight had turned towards soilless cultivation as a promising avenue to tackle the trials of continuous cropping. The future of research must be grounded in the interconnected “plant-soil-microbe” system，combining the ecological environment and cultivation conditions of nurturing root and rhizome authentic medicinal materials in the region. The focus should be on unraveling the intricate mechanisms governing the interplay between root and rhizome medicinal plants and soil microbes，delving into the biological and ecological rationale of continuous cropping challenges to surmount the critical technical barriers. Concurrently，efforts should be directed towards the development of resilient varieties，fine-tuning cultivation and management techniques，and exploring strategies for soil microbial regulation and ecological rejuvenation，effectively mitigating the adverse impact of continuous cropping hurdles on the growth and productivity of medicinal plants.