In recent years, international and domestic academics have made a series of studies on the mechanism of icariin which is the main effective component of Herba Epimedii, to accelerate fracture healing. The current research results show that the mechanism of icariin accelerating fracture healing is to promote the migration and homing of BMSCs and ASCs by activating Wnts, BMP, MAPK, ER and other related signal pathways, so as to carry out osteogenic differentiation into osteoblasts. At the same time, it can promote the maturation and mineralization of osteoblasts to form callus, and inhibit the bone resorption activity of osteoclasts. This article reviews the mechanism of icariin in accelerating fracture healing from the aspects of its effects on related cells and vascular remodeling, so as to provide reference for the follow-up research.