Abstract：Objective：To observe the clinical effect of Shenmai injection combined with butylphthalide for acute cerebral infarction complicated with diabetes mellitus. Methods： A total of 78 cases of patients with acute cerebral infarction complicated with diabetes mellitus were selected and divided into the control group and the observation group according to the random number table method，39 cases in each group. Both groups were given routine thrombolytic treatment and basic treatment for diabetes mellitus. The control group was given butylphthalide by intravenous drip，and the observation group was additionally treated with Shenmai injection based on the treatment of the control group. The clinical effect，the scores of National Institutes of Health Stroke Scale(NIHSS)， hemorheological indexes， and the expression levels of neutrophil to lymphocyte ratio(NLR)， brain natriuretic peptide(BNP)， homocysteine(Hcy) and inflammatory factors were compared between the two groups. Results：Before treatment，compared the scores of NIHSS，whole blood viscosity of high shear，whole blood viscosity of low shear，plasma viscosity(PV)，erythrocyte aggregation index，and the levels of fibrinogen(Fbg) between the two groups，there was no significance in differences(P＞0.05). After treatment，the scores of NIHSS，whole blood viscosity of high shear，whole blood viscosity of low shear，PV，erythrocyte aggregation index，and the levels of Fbg in the two groups were decreased when compared with those before treatment(P＜0.05)； the above indexes in the observation group were lower than those in the control group(P＜0.05). Before treatment， compared the levels of NLR，C- reactive protein(CRP)， tumor necrosis factor- α(TNF- α)， interleukin- 6(IL- 6)， BNP and Hcy between the two groups，there was no significance in differences(P＞0.05). After treatment，the levels of NLR，CRP，TNF-α，IL-6，BNP and Hcy in the two groups were decreased when compared with those before treatment(P＜0.05)， and the above levels in the bservation group were lower than those in the control group(P＜0.05). The total effective rate was 84.62% in the observation group，higher than that of 64.10% in the control group，the difference being significant(P＜0.05). Conclusion：The therapy of Shenmai injection combined with butylphthalide has significant clinical effect in treating acute cerebral infarction complicated with diabetes mellitus， which can promote the recovery of cerebral nerve function， reduce the levels of NLR， BNP and Hcy，inhibit inflammatory responses，and improve the prognosis of acute cerebral infarction.