Abstract： Objective： To observe the clinical effect of the combination use of Tongbi Huoluo Decoction and intravenous thrombolysis with Alteplase on acute cerebral infarction with syndrome of qi deficiency and blood stasis. Methods：A total of 122 patients with acute cerebral infarction with syndrome of qi deficiency and blood stasis admitted to the Department of Neurology， Chinese Medicine Hospital of Puyang from January 2021 to December 2023 were selected and divided into the observation group （62 cases） and the control group （60 cases） according to the treatment method. Both groups were given basic therapy. The control group was additionally treated with intravenous thrombolysis with Alteplase，and the observation group was additionally treated with Tongbi Huoluo Decoction based on the treatment in the control group. Both groups were treated for four weeks and followed up for three months. The clinical effects，and the changes before and after treatment in traditional Chinese medicine syndrome scores，neurological function [scores of National Institutes of Health Stroke Scale （NIHSS）]， hemodynamics [mean blood flow velocity （Vm） of anterior cerebral artery（ ACA），middle cerebral artery（ MCA） and posterior cerebral artery（ PCA）] were compared between the two groups；the prognosis in the two groups at the third months of follow-up [Barthel Index（BI）] was recorded. Results： After treatment，the total effective rate was 98.39% （61/62） in the observation group，which was higher than that of 86.67%（ 52/60） in the control group（ P＜0.05）. After treatment，the traditional Chinese medicine syndrome scores and NIHSS scores in the two groups were decreased when compared with those before treatment （P＜0.05），and the above scores in the observation group were lower than those in the control group （P＜0.05）. The Vm of ACA，MCA and PCA in the two groups was elevated when compared with that before treatment （P＜0.05），and the Vm of ACA，MCA and PCA in the observation group was faster than that in the control group （P＜0.05）. After three months of follow-up，BI in the observation group was higher than that in the control group （P＜0.05）. Conclusion：The combination use of Tongbi Huoluo Decoction and intravenous thrombolysis with Alteplase has a great clinical effect on acute cerebral infarction with syndrome of qi deficiency and blood stasis，which can relieve clinical symptoms and improve cerebral artery blood flow perfusion， and promote the recovery of neurological function and improvements in prognosis.