Silver nanoparticles (AgNPs) are widely used as antibacterial products in various fields. Recent studies have suggested that AgNPs need an appropriate stabilizer to improve their stability. Some antibacterial traditional Chinese medicines (TCMs) contain various reductive components, which can not only stabilize AgNPs but also enhance their antimicrobial activity. In this study, we developed a series of novel AgNPs using a TCM extract as a stabilizer, reducing agent, and antimicrobial agent (TCM-AgNPs). A storage stability investigation of the TCM-AgNPs suggested a significant improvement when compared with bare AgNPs. Further, conjugation of TCMs onto the AgNP surface resulted in stronger antimicrobial potency on antibacterial evaluation using
Pseudomonas aeruginosa
,
Staphylococcus epidermidis
, and
Staphylococcus aureus
with minimum inhibitory concentration 50% (MIC
50
) ratios (and minimum bactericidal concentration 90% [MBC
90
] ratios) of AgNPs to respective TCM-AgNPs as assessment indices. Among these,
P. cuspidatum
Sieb. et-conjugated AgNPs (
P.C.
-AgNPs) had the advantage of a combination of TCMs and AgNPs and was studied in detail with regard to its synthesis and characterization. The extraction time, reaction temperature, and concentrations of AgNO
3
and
Polygonum cuspidatum
Sieb. et extract were critical factors in the preparation of
P.C.
-AgNPs. Further, the results of X-ray diffraction and Fourier transform infrared spectroscopy indicated successful preparation of
P.C.
-AgNPs. In representative studies,
P.C.
-AgNPs showed a well-defined spherical shape, a homogeneous small particle size (36.78 nm), a narrow polydispersity index (0.105), and a highly negative zeta potential (−23.6 mV) on transmission electron microscopy and dynamic light scattering. These results indicate that TCM-AgNPs have a potential role as antibacterial agents in the clinic setting.