Abstract：Objective：To observe the clinical efficacy of modified Xifeng Huatan Tongqiao Prescription combined with Alteplase intravenous thrombolysis on acute cerebral infarction (ACI) with wind-phlegmblood stasis obstruction syndrome. Methods：A total of 88 cases of ACI patients with wind-phlegm-blood stasis obstruction syndrome were divided into the trial group and the control group according to the random number table method， with 44 cases in each group. Both groups received routine basic treatment； the control group was additionally treated with Alteplase intravenous thrombolysis， and the trial group was additionally treated with modified Xifeng Huatan Tongqiao Prescription based on the treatment of the control group. Both groups were treated for four weeks. Traditional Chinese medicine (TCM) syndrome scores， National Institutes of Health Stroke Scale (NIHSS) scores， cerebral hemodynamics， and hemorheology indexes were compared before and after treatment in both groups；the clinical efficacy and the incidence of adverse reactions were compared between the two groups. Results： After treatment， the total effective rate was 93.18% in the trial group， which was higher than that of 77.27% in the control group (P＜0.05). After treatment， TCM syndrome scores， NIHSS scores， whole blood high shear viscosity， whole blood low shear viscosity， red blood cell hematocrit， and platelet aggregation rate in the two groups were decreased when compared with those before treatment (P＜0.05)，and the blood flow velocity of bilateral anterior cerebral artery (ACA)，posterior cerebral artery (PCA)，middle cerebral artery (MCA)，and left and right vertebral artery (VA) were increased (P＜0.05). The blood flow velocity of ACA，PCA，MCA，and left and right VA in the trial group was faster than that in the control group (P＜0.05)， and TCM syndrome scores，NIHSS score，and various hemorheology indicators were lower than those in the control group (P＜ 0.05). The incidence of adverse reactions in the trial group and the control group was 9.09% and 11.36% respectively， and the difference was not significant (P＞0.05). Conclusion： The combination of modified Xifeng Huatan Tongqiao Prescription and Alteplase intravenous thrombolysis has a definite curative effect in the treatment of ACI with wind-phlegm-blood stasis obstruction syndrome， which can promote cerebral blood circulation in patients， improve neurological deficits and hemorheology indicators， and has high safety.