The invention discloses a preservation method of traditional Chinese medicine decoction pieces. The method comprises the following steps: step one, carrying out drying treatment on the traditional Chinese medicine decoction pieces, vertically stacking the traditional Chinese medicine decoction pieces together, packaging with a paper box, and carrying out radiation treatment with 60 Co-gamma rays,wherein the absorbed dose of radiation is 1.0 to 1.5 kGy, a rotating shaft is inserted in the middle part of the paper box in a penetrated manner, and the paper box rotates around the rotating shaft;step two, carrying out vacuum sealing on the traditional Chinese medicine decoction pieces after treatment in the step one, and carrying out secondary radiation treatment, wherein the absorbed dose ofradiation is 2.0 to 2.5 kGy; and step three, putting the traditional Chinese medicine decoction pieces obtained in the step two into a sealed container, inflating a gas mixture of 72% of nitrogen, 25% of carbon dioxide gas and 3% of oxygen into the sealed container, and sealing for storage. According to the method, the uniformity is guaranteed by using mutual compensation of upper and lower surfaces in an equivalent dose area, so that the preservation effect is improved.