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Integrating Traditional Chinese Medicine (TCM) with Western medical treatments enhances cancer patients' survival rates and quality of life. However, there is a lack of large-scale studies on the integration of TCM with immune checkpoint inhibitors (ICIs) or chemotherapy in cancer treatment. This retrospective cohort study analyzed data from the Taiwan National Health Insurance Research database and Taiwan Cancer Registry, including 2,512 patients treated with ICIs and 130,010 with chemotherapy between January 1, 2019, and June 30, 2021. Patients receiving TCM were classified as TCM users, while those who did not were nonusers. The primary outcome was all-cause mortality, assessed using Cox proportional hazards regression to estimate hazard ratios (HR) with 95% confidence intervals (CI), adjusting for demographics and comorbidities. Among ICI-treated patients, TCM users (n=720) had lower mortality rates than nonusers (n=1,792), with an incidence of 45.84 vs. 83.72 per 100 person-years (adjusted HR: 0.58; 95% CI: 0.51-0.66). Similarly, in chemotherapy-treated patients, TCM users (n=51,292) had reduced mortality (11.54 vs. 24.86 per 100 person-years; adjusted HR: 0.59; 95% CI: 0.57-0.60). These associations remained consistent across subgroup and sensitivity analyses. Commonly used TCM herbs included Hedyotis diffusa Willd (Bai Hua She She Cao), Scutellaria barbata (Ban Zhi Lian), and Astragali Radix (Huang Qi). These findings suggest that TCM use alongside ICIs or chemotherapy is associated with lower mortality, even after adjusting for confounders. Further prospective studies are needed to confirm these results and explore underlying mechanisms, advancing integrative cancer care.