Tongue diagnosis in traditional Chinese medicine (TCM) assesses the health by investigation of tongue coating. The science and technology of tongue coating analysis have become a significant issue for modernization of TCM. The relationship between microecology of tongue coating and TCM was relevant to the syndrome differentiation in TCM, such as the cold/hot syndrome may exhibit different specific microbiota patterns in the tongue coating. This article provides a review on the microbiota research of tongue coating.