Objective To explore the relationship between teacher-student communication (TSC) and cognition (knowledge), identification (faith), daily application and propaganda (behavior) of Traditional Chinese Medicine (TCM) of international students, and provide suggestions for enhancing identification and dissemination of TCM. Methods In June 2021, 304 international students majoring in TCM, acupuncture and massage in Shandong University of Traditional Chinese Medicine were selected as the research participants. The TSC, the cognition, faith, behavior of TCM were investigated. Using structural equation model to analyze the relationship between TSC and knowledge, faith and behavior of TCM. Results Foreign students scored (14.69 ± 3.17) on TSC (20 points in total), (13.40 ± 4.78) on Chinese medicine cognition (20 points in total), (11.88 ± 2.08) on Chinese medicine identity and belief (15 points in total), and (15.70 ± 3.63) on Chinese medicine application and transmission (20 points in total). The TSC indirectly affected the daily application and communication of foreign students through their recognition, identification and belief in Chinese medicine (b=0.349, P=0.008), or only through their recognition and belief in Chinese medicine (b=0.918, P=0.001). Conclusions The communication between teachers and students and the knowledge, belief and practice of TCM of international students need to be improved. The communication between teachers and students can affect the knowledge, belief and practice of TCM of international students. The quality of communication between teachers and students of international students majoring in TCM should be effectively improved, the international education program of TCM should be optimized, and the awareness and identity of these students should be constantly improved, so as to promote the spread of TCM culture.