Abstract：Objective：To observe the clinical effect of modified Xuefu Zhuyu tang combined with western medicine for ischemic stroke. Methods：A total of 140 cases of patients with ischemic stroke were divided into the control group and the Chinese medicine group according to the random number table method， 70 cases in each group. The control group was treated with aspirin combined with clopidogrel based on routine treatment，and the Chinese medicine group was additionally treated with modified Xuefu Zhuyu tang based on the treatment of the control group. Both groups were treated for four weeks. Before and after treatment， the levels of prothrombin time(PT)， activated partial thromboplastin time(APTT)， thrombin time(TT)，fibrinogen(FIB)，D-dimer(D-D) in plasma，cytochrome C(CytC) and caspase-3 in serum as well as the National Institutes of Health Stroke Scale(NIHSS) scores in the two groups were compared. The clinical effect in the two groups were evaluated and compared. Results：After treatment，PT in the two groups were prolonged when compared with those before treatment，TT were shortened，and the levels of FIB，D- D，CytC and Caspase- 3 as well as NIHSS scores were decreased，differences being significant(P＜0.05)；PT in the Chinese medicine group was longer than that in the control group，TT was shorter，and the levels of FIB，D-D，CytC and Caspase-3 as well as NIHSS score were lower，differences being significant(P＜0.05). Before and after treatment， there was no significant difference in the comparison of APTT between two groups(P＞0.05). The total effective rate was 91.43% in the Chinese medicine group and 78.57% in the control group， the difference being significant(P＜0.05). Conclusion： The therapy of modified Xuefu Zhuyu tang combined with western medicine for ischemic stroke can improve coagulation function and neurological function，and reduce the levels of CytC and Caspase-3 in serum，whose curative effect is better than that of simple western medicine.