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Objective To analyze the changes in the recognition of traditional Chinese medicine (TCM) among residents before and after the outbreak of COVID-19 and TCM influencing factors to provide a reference for promoting the popularization of TCM. Methods An online questionnaire survey was conducted among residents in mainland China to examine changes in knowledge, trust, and attitudes toward the development prospect of TCM before and after the outbreak of COVID-19 and to analyze the relevant influencing factors. Results A total of 3,067 questionnaires were returned, with 2,975 valid questionnaires and a valid response rate of 97. 00%. After the outbreak of COVID-19, the percentage of residents who had at least "know some" of TCM increased from 47.97% to 59.36%; the percentage of those who had at least "trust to some extent" in TCM increased from 65.44% to 71.29%, and the percentage of those who had at least "modest optimism" about the development prospect of TCM increased from 68.94% to 77.01%. Age, education, residence, basic medical insurance for urban and rural residents and whether to choose TCM were the influencing factors for positive changes in residents' recognition, age and education were the influencing factors for positive changes in residents' trust, and age, gender, residence and profession were the influencing factors for positive changes in residents' development prospect attitudes toward TCM after the outbreak of COVID-19 (P<0.05). Conclusion The overall recognition of TCM among residents has increased since the outbreak of COVID-19, but there is still a need to adopt multiple means of publicity to promote the popularization of TCM knowledge and enhance the recognition of TCM in residents. [ABSTRACT FROM AUTHOR]