Abstract： Objective： To observe the clinical effect of Annao Tablets combined with Oxiracetam on vascular dementia (VD) after stroke with internal exuberance of heat toxin syndrome. Methods：A total of 100 patients of VD after stroke with internal exuberance of heat toxin syndrome were selected and divided into the treatment group and the control group according to the random number table method ， with 50 cases in each group. The control group was treated with Oxiracetam， and the treatment group was treated with Annao Tablets combined with Oxiracetam. Both groups were treated for 4 weeks. The clinical effects and incidence of adverse reactions were compared between the two groups. The neurological function，cognitive function，degree of dementia and activitees of daily living were evaluated by National Institutes of Health Stroke Scale (NIHSS)， Mini- Mental State Examination (MMSE)， Clinical Dementia Rating (CDR) and Activities of Daily Living (ADL)；the mean blood velocity of bilateral middle cerebral artery (MCA)，basilar artery (BA)，anterior cerebral artery (ACA) and vertebral artery (VA)，as well as the levels of serum brain- derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF) were compared. Results：After treatment，the total clinical effective rate was 96.00% in the treatment group， higher than that of 82.00% in the control group (P＜0.05). After treatment，the scores of NIHSS and CDR were decreased when compared with those before treatment (P＜0.05)，and the scores of MMSE and ADL were increased compared with those before treatment (P＜0.05)； the scores of NIHSS and CDR in the treatment group were lower than those in the control group (P＜0.05)，and the scores of MMSE and ADL were higher than those in the control group (P＜0.05). After treatment，the blood velocity of BA，MCA，VA and ACA in the two groups were increased when compared with those before treatment (P＜0.05)，and the blood velocity of BA， MCA， VA and ACA in the treatment group were higher than those in the control group (P＜0.05). After treatment，the levels of serum BDNF and VEGF in the two groups were increased when compared with those before treatment (P＜0.05)，and the above 2 levels in the treatment group were higher than those in the control group (P＜0.05). During treatment，the incidence of adverse reactions was 10.00% in treatment group， and was 8.00% in the control group， there being no significance in the difference (P＞0.05). Conclusion： Based on the treatment of Oxiracetam， Annao Tablets for VD after stroke with internal exuberance of heat toxin syndrome can enhance the clinical effect， promote the recovery of cognitive function and neurological function in patients，increase the cerebral blood velocity and levels of serum BDNF and VEGF，and improve the quality of life，with less adverse reactions.