Abstract Purpose: To investigate the current status of adolescents’ Traditional Chinese Medicine health literacy (TCMHL) conceptualized as a domain-specific form of health literacy, analyze the relationship among online social support (OSS), Internet self-efficacy (ISE) and TCMHL, and explore the indirect association between OSS and TCMHL through ISE in a cross-sectional model. Methods: From August to September 2025, convenience sampling was used to select 393 adolescents in China.