<p>Alzheimer’s disease (AD) is a multifactorial neurodegenerative disorder characterized by β-amyloid (Aβ) plaque deposition, tau hyperphosphorylation, neuroinflammation, and oxidative stress. However, current therapies remain largely symptomatic. Traditional Chinese Medicine (TCM)-derived monomers exhibit considerable anti-AD potential owing to their multitarget neuroprotective activities. However, their therapeutic translation is severely limited by poor stability, low bioavailability, and restricted brain delivery across the blood-brain barrier (BBB). This review summarizes the pathological basis of AD, the neuroprotective mechanisms of representative TCM-derived monomers, and the major BBB-related barriers that hinder effective brain delivery. Particular emphasis is placed on lipid-based nanocarriers, including exosomes, liposomes, solid lipid nanoparticles (SLNs), and nanostructured lipid carriers (NLCs), as platforms for improving drug stability, BBB transport, and brain accumulation. We further highlight innovative delivery strategies that integrate ligand-mediated targeting with biomimetic modification, particularly cell membrane camouflage and exosome-inspired engineering. These approaches may confer immune evasion, prolonged circulation, enhanced biocompatibility, and improved lesion-oriented delivery. Finally, we discuss the challenges facing the clinical translation of lipid-based nanocarriers, including large-scale production, quality control, regulatory considerations, and long-term safety. Collectively, these lipid-based nanoplatforms provide a promising framework for advancing next-generation nano-TCM therapeutics for AD. Future progress will depend on optimized carrier design, rigorous mechanistic validation, comprehensive long-term safety assessment, and clinically relevant translational studies.</p> Graphical abstract <p></p>