This paper combines the perspectives of the history of the body and the history of medicine, using a method of mutual verification through text and images, to systematically organize and compare descriptions of the kidney organ from ancient Chinese medical literature and foreign literature. By analyzing the process of depicting kidney organ images, this study reveals ancient medical practitioners’ understanding of the kidney organ’s essence and the visual representation of the Mingmen (命门) theory. It particularly elucidates the significant role of the Mingmen theory in the formation of the “kidney’s bodily perspective” theoretical framework, as well as the profound influence of the concept that “the kidney is the root of innate essence” on the evolution of Chinese medicine’s organ imagery. The study found that: ① The images of the kidneys and the Mingmen form the core schematic units of the theory of Chinese medicine’s zang-fu organs; ② The images of the Mingmen exhibit significant characteristics of theoretical construction and can be regarded as important derivative products of the theory of the kidneys; ③ From the Jin-Yuan period to the Ming-Qing period, the theory of the Mingmen reinforced the innate attributes of the kidneys and elevated their status in the Chinese medicine body cognition system; ④ As the Mingmen theory became systematized, the bodily implications of the kidney underwent a paradigm shift from an anatomical entity to a functional entity. This study employs a dual interpretive approach combining iconographic analysis and theoretical exposition to reveal the visual construction logic and mechanisms underlying TCM organ cognition, offering a new approach that integrates iconography and medical history for research on the TCM conception of the body.