The invention relates to a tongue picture image evaluation method, which comprises the following steps of: 1, acquiring tongue picture images of an object at different periods, and acquiring tongue picture image characteristic indexes; S; step 2, selecting a first tongue picture image of the object, and obtaining a first tongue picture image feature index point A; S; step 3, selecting a second tongue picture image of the object, and obtaining a second tongue picture image feature index point B; 4, establishing a tongue picture image feature index coordinate system, and selecting a reference tongue picture image feature index point C; S; step 5, connecting AB and AC, and acquiring a projection point D of B on the AC; S; step 6, evaluating the second tongue image according to a formula (shown in the specification), wherein the formula (shown in the specification) of the second tongue image is shown in the specification, and the formula (shown in the specification) of the second tongue image is shown in the specification; 7, judging whether S is greater than 0 or not, and if S is greater than 0, determining that the second tongue image is good; O; otherwise, t, the difference is determined;. The method has the advantages that the tongue image image is quantized through a formula, t, the change trend of the tongue image is reflected, and qualitative analysis is carried out on the tongue image; A; and the evaluation effect is objective, t, the practicability is high, and the application range is wide.