Abstract： Objective： To observe the clinical effect of Xingnaojing injection combined with western medicine for acute ischemic stroke(AIS). Methods：A total of 100 cases of AIS patients were selected and divided into the study group and the control group according to their different treatment methods， with 50 cases in each group respectively. The control group was treated with western medicine， and the study group was additionally treated with Xingnaojing injection based on the treatment of the control group. Both groups were treated for two weeks. The neurological function， cognitive function and levels of inflammatory factors before and after treatment as well as clinical effects and incidences of adverse reactions in the two groups were compared. Results：The total effective rate was 88.00% in the study group， better than that of 72.00% in the control group(P＜0.05). After treatment， the scores of National Institute of Health Stroke Scale(NIHSS) and the levels of interleukin- 6(IL-6)， tumor necrosis factor- α(TNF-α) and high-sensitivity c-reactive protein(hs-CRP) in serum in the two groups were decreased when compared with those before treatment， and the scores of Montreal Cognitive Assessment (MoCA) were increased(P＜0.05)；the NIHSS score and the levels of IL-6， TNF-α and hs-CRP in serum in the study group were lower than those in the control group(P＜0.05)， and MoCA score was higher(P＜0.05). The incidence of adverse reactions was 6.00% in the study group and 8.00% in the control group， there being no significance in the difference(P＞ 0.05). Conclusion： Xingnaojing injection combined with western medicine for AIS has a definite curative effect， and can effectively improve neurological function and cognitive function and relieve inflammatory responses with good safety.