Abstract：Objective：To observe the effect of Tiaozhi tang on hemorheology and carotid atherosclerotic plaque in patients with acute cerebral infarction. Methods： A total of 92 cases of patients with acute cerebral infarction were selected and divided into the control group and the observation group according to the random number table method， with 46 cases in each group. The control group was treated with routine western medicine，and the observation group was additionally treated with Tiaozhi tang based on the treatment of the control group. The clinical effects in the two groups were evaluated. Before and after treatment，the levels of interleukin-6(IL-6)，tumor necrosis factor(TNF-α)，hypersensitive C-reactive protein(hs- CRP) ， total cholesterol(TC) ， triglyceride(TG) ， high- density lipoprotein cholesterol(HDL- C) and low- density lipoprotein cholesterol(LDL-C) in serum in the two groups were compared. The changes in hemorheology indexes including whole blood high shear viscosity，whole blood low shear viscosity and blood viscosity as well as the indexes of carotid ultrasonography including carotid arterial diameter， end diastolic velocity， peak systolic velocity， carotid intima- media thickness(IMT) and Crouse plaque scores were detected. Results：The total effective rate was 78.26% in the observation group，higher than that of 58.70% in the control group， the difference being significant(P＜0.05). After treatment， the levels of IL- 6， TNF- α， hs- CRP，TG，TC and LDL- C in serum in the two groups were significantly decreased when compared with those before treatment(P＜0.05)，and the above levels in the observation group were significantly lower than those in the control group(P＜ 0.05)；the levels of serum HDL-C in the two groups were significantly increased when compared with those before treatment (P＜0.05)， and the level in the observation group was significantly higher than that in the control group(P＜0.05). After treatment，whole blood high shear viscosity，whole blood low shear viscosity and blood viscosity in the two groups were significantly decreased when compared with those before treatment(P＜0.05)， and the above indexes in the observation group were significantly lower than those in the control group(P＜0.05). After treatment，the carotid arterial diameters in the two groups were significantly increased when compared with those before treatment(P＜0.05)， and the one in the observation group was significantly higher than that in the control group(P＜0.05). The end diastolic velocity， peak systolic velocity，IMT and Crouse plaque scores in the two groups were significantly decreased when compared with those before treatment(P＜0.05)，and the above indexes in the observation group were significantly lower than those in the control group (P＜0.05). Conclusion：The application of Tiaozhi tang for acute cerebral infarction has a significant curative effect，and can effectively reduce inflammatory responses，regulate blood lipid levels，improve hemorheology indexes and reduce the area of carotid atherosclerotic plaque.