Purpose/Significance To construct a knowledge structure model for traditional Chinese medicine (TCM) medical cases, so as to provide support for TCM clinical practice, teaching and research, enhance the application value of TCM medical cases, and open up new paths for the research. Method/Process Five levels of the knowledge pyramid are explained, construction principles that align with TCM theory and clinical practice orientation are proposed to design the system framework. The knowledge elements of TCM medical cases are stratified, and a pyramid knowledge structure model for TCM medical cases is constructed. Result/Conclusion A knowledge structure model for TCM medical cases is constructed, and knowledge at different levels is classified and organized. The model provides new ideas and methods for TCM medical cases research, points out the direction and suggestions for improvement, and offers strong support for in-depth research on TCM medical cases.