Repetitive transcranial magnetic stimulation (rTMS), as a non-invasive neuromodulation technique, regulates the activity of the neurons in specific brain regions through varying magnetic fields, thereby achieves excitatory or inhibitory modulation in targeted brain areas. which offers a novel therapeutic approach for stroke rehabilitation. In rTMS treatment for stroke, significant therapeutic effects can be achieved by adjusting parameters such as the frequency, intensity, duration, and location of the stimulation, as well as optimizing personalized rehabilitation protocols. This paper reviews the fundamental principles of rTMS, the mechanisms of rTMS in stroke rehabilitation, the clinical applications of rTMS in the rehabilitation of motor function, language function, and cognitive function in patients with stroke, the optimization of rTMS parameter settings and rehabilitation protocol design, as well as the current challenges and the future prospects in clinical practice of rTMS, in order to help clinicians provide more effective rTMS treatment for stroke, thereby improve patients' quality of life and functional recovery.