Abstract： Iron overload is a common complication of hematological diseases， mostly due to iron metabolism malfunction or transfusion dependence. In traditional Chinese medicine (TCM)，blood stasis is the key pathological mechanism in the process of iron overload，and the treatment is to activate blood and eliminate stasis. Modern research has shown that iron overload can produce oxidative stress in the formation of organs and tissues，then induce ferroptosis to affect the bone marrow microenvironment and damage hematopoietic cells. The transformation of iron overload—ferroptosis is similar to the evolution of clinical deficiency and stasis over time，difficulty in producing new blood，loss of moistening of the internal organs，and accumulation of toxicity. The authors expound the evolution of pathogenesis and the effect of intervention of TCM from the viewpoint of“deficiency，stasis and toxicity” to the development of iron overload to iron death in combination with modern medicine studies，so as to provide a train of thought for the clinical treatment of iron overload.