Objective To discuss TCM syndrome type distribution,composition ratio and features,and clinical symptoms of bipolar affective disorder and provide evidence for establishing common TCM syndrome standards of this disorder. Methods Four TCM diagnostic methods were used to differentiate TCM syndromes and investigate syndrome index in 482 patients with bipolar affective disorder in the Department of Psychiatry,Beijing Anding Hospital. Meanwhile,Yong’s manic depression self rating scale（USES）and SDS scale were used to assess their manic and depressive condition. Results Bipolar manic episode（hereinafter referred to as bipolar mania）and bipolar depressive episode（hereinafter referred to as bipolar depression）patients’ number in six types of interior disturbance of phlegm fire,disharmony of heart and kidney,damp-heat of liver and gallbladder,and liver and kidney Yin deficiency had no significant differences（P>0.05）. The number of patients diagnosed with interior disturbance of phlegm fire in bipolar mania and bipolar disorder was the highest. The patients with interior disturbance of phlegm fire got the highest scores in the number of sub-scales like sexual interest,irritability,speaking speed and sum. Those with qi stagnation and blood stasis got the highest score in thinking disorder. Those with damp-heat of liver and gallbladder scored the highest in destructive aggression.The above three had significant differences with other 5 kinds of syndrome types（P<0.01）. Conclusion Interior disturbance of phlegm fire is the main pathogenesis of bipolar affective disorder. The patients with interior disturbance of phlegm fire,liver stagnation and blood stasis,and damp-heat of liver and gallbladder have their own manifestations. Various types of patients with bipolar depression get similarities in sub-scales like depressive mood,somatic manifestations and cognitive behavioral disorder.