Ferroptosis, a precisely regulated cell death mechanism, is distinguished by its intimate link to iron overload and lipid peroxidation processes, playing a pivotal role in the pathological progression of a wide range of diseases. In postmenopausal women suffering from osteoporosis, reduced muscle strength and impaired balance lead to a heightened risk of fragility fractures, markedly diminishing their quality of life. Recent groundbreaking research has underscored the crucial role of the ferroptosis mechanism in the initiation and progression of musculoskeletal diseases. This discovery not only enriches our understanding of disease mechanisms but also heralds ferroptosis pathways as novel and promising therapeutic targets for treating these conditions. Traditional Chinese Medicine (TCM) has exhibited remarkable efficacy in managing musculoskeletal diseases, with studies validating its ability to modulate ferroptosis mechanisms and profoundly impact disease regulation. This portends vast research potential and significant therapeutic promise for the future. By delving deeper into the interplay between ferroptosis and sarcopenia-osteoporosis in postmenopausal women, and by developing innovative therapeutic strategies and TCM interventions, we aspire to forge new pathways for the treatment of sarcopenia-osteoporosis in this patient population.