Traditional Chinese veterinary medicine (TCVM) which includes acupuncture, herbal medicine, Tui-Na (massage) and food therapy has unique therapeutic effects for chronic kidney disease (CKD). It has become increasingly popular as a sole or integrated therapy for managing CKD in dogs and cats. There is growing evidence in human and laboratory research for the effectiveness of acupuncture and Chinese herbal medicine in preventing kidney disease and improving kidney function in CKD. Generally, acupuncture and herbal medicine can be used for relieving pain, reducing inflammation, improving kidney functions, addressing clinical signs associated with CKD, and improving overall well-being. Management of CKD in TCVM is based on pattern differentiation, which include Kidney Qi Deficiency, Kidney Yang Deficiency, Kidney Yin Deficiency and Kidney Jing Deficiency. Pattern diagnosis, treatment principle and strategy using acupuncture, Chinese herbal medicine, and Tui-na therapy for the treatment of CKD will be discussed in this article.