Abstract：Objective：To observe the clinical effect of the therapy of Angong Niuhuang Pills combined with western medicine on acute ischemic stroke (AIS) with syndrome of internal block of phlegm-heat and its effects on neurological impairment degree，blood lipid indexes and hemorheology. Methods：A total of 64 cases of patients with AIS with syndrome of internal block of phlegm-heat were selected and divided into the control group and the study group according to the random number table method，with 32 cases in each group. During the study，2 cases were excluded from each of the two groups，finally 30 cases were included in both group. The control group was treated with western medicine， and the study group was additionally treated with Angong Niuhuang Pills based on the treatment of the control group. The two groups were treated for 14 days. The clinical effects， the levels of blood lipid indexes [low-density lipoprotein cholesterol (LDL-C)，total cholesterol (TC)，triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C)]， and hemorheology indexes [plasma viscosity (PSV)， low-shear blood viscosity (LSV)， high-shear blood viscosity (HSV) and fibrinogen (FIB)]， and the scores of National Institute of Health Stroke Scale (NIHSS) were compared between the two groups. The incidence of adverse reactions was recorded. Results：After 14 days of treatment， the total effective rate was 100% in the study group， compared with that of 93.33% in the control group， differences being no significance(P＞0.05). After 3， 7 and 14 days of treatment，the levels of serum TG，TC and LDC-C in the two groups were respectively decreased when compared with those before treatment (P＜0.05)，and the above three levels in the study group were lower than those in the control group at the same stage (P＜0.05)； the serum HDL-C levels in the two groups were increased when compared with those before treatment (P＜0.05)，and the serum HDL-C level in the study group was higher than that in the control group at the same stage (P＜0.05). After 3，7 and 14 days of treatment， the levels of PSV， LSV， HSV and FIB in the two groups were respectively decreased when compared with those before treatment (P＜0.05)，and the above four levels in the study group were lower than those in the control group at the same stage (P＜0.05). After 3， 7 and 14 days of treatment， the NIHSS scores in the two groups were decreased when compared with those before treatment (P＜0.05)， and the NIHSS score in the study group was lower than that in the control group at the same stage (P＜ 0.05). During treatment， there was no obvious adverse reaction in the two groups. Conclusion： The therapy of Angong Niuhuang Pills combined with western medicine has a significant curative effect on AIS with syndrome of internal block of phlegm-heat， which can help mitigate the neurological impairment degree，regulate the blood lipid metabolism and improve the hemorheology indexes，with great safety.