Abstract： Objective： To observe the clinical effect of Yiqi Tongmai Prescription combined with conventional western medicine on H-type hypertension complicated with acute ischemic stroke. Methods：A total of 80 patients with H-type hypertension complicated with acute ischemic stroke admitted to Henan Integrative Medicine Hospital from January 2022 to January 2024 were randomly divided into the control group and the treatment group，with 40 patients in each group. The control group received conventional western medicine treatment，while the treatment group received a combination of Yiqi Tongmai Prescription and conventional western medicine treatment. Compared the traditional Chinese medicine（TCM）syndrome scores， National Institutes of Health Stroke Scale （NIHSS） scores， systolic and diastolic blood pressure，and serum homocysteine （Hcy） levels between the two groups before and after treatment，and evaluated the clinical efficacy and incidence of adverse reactions between the two groups. Results： After treatment， the total effective rate was 92.50%（ 37/40） in the treatment group，which was higher than that of 75.00%（ 30/40） in the control group（ P＜0.05）. After treatment，the TCM syndrome scores，NIHSS score，systolic blood pressure，diastolic blood pressure，and serum Hcy levels in both groups were lower than those before treatment （P＜0.05），and the TCM syndrome score， NIHSS score， systolic blood pressure， diastolic blood pressure， and serum Hcy level in the treatment group were lower than those in the control group （P＜0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （P＞0.05）. Conclusion： The combination of Yiqi Tongmai Prescription and conventional western medicine has a definite therapeutic effect on H-type hypertension complicated with acute ischemic stroke，which can lower the patient's blood pressure levels，improve neurological function，and has high safety.