Traditional Chinese medicine (TCM) injections originated in China and have been extensively used in clinic. However, some events the adverse drug reactions (ADRs) have been reported, among which, hypersensitivity reactions (HSRs) are the main ADRs of TCM injections. To solve the ADRs of TCM injections will be the key to proceed of the modernization of TCM. This paper reviewed the current situation and causes of the ADRs of TCM injections. On the basis of primary findings obtained from the project granted by the Ministry of Science and Technology, two pivotal technologies of the safety evaluation of TCM injections were introduced, which are anaphylactoid reaction ussessment and metabonomics for TCM injections. It is expected to provide some new ideas for the breakthrough of the safety evaluation of TCM injections.