Neutrophil elastase (NE) is a major protease in neutrophil primary granules, involved in the occurrence and development of complex pathology of bronchiectasis, with a variety of biological functions such as regulating inflammatory response, controlling infection, increasing mucus secretion, degrading extracellular matrix and cytokines, and damaging the immune system, and has important correlations with disease prognosis, NE can be used as a predictor of clinical treatment outcome and a possible therapeutic target. There are not a large number of high-level clinical studies demonstrating the efficacy of endogenous and exogenous NE inhibitors in bronchiectasis. Traditional Chinese medicine plays its role in multi-target, multi-pathway and precise treatment to intervene in NE-mediated bronchiectasis, which has advantages in improving clinical symptoms, reducing the number of acute exacerbations, and reducing airway inflammatory response.This article analyzes the main biological functions of NE in bronchiectasis and the progression of traditional Chinese medicine intervention in NE-mediated airway inflammation, hoping to provide valuable reference for clinical and scientific researchers.