Abstract： Objective： To observe the clinical efficacy of acupuncture combined with Tirofiban on patients with hyperacute ischemic stroke beyond the time window， and to explore its effects on platelet function and cerebral blood flow. Methods：A total of 60 patients with hyperacute ischemic stroke beyond the time window who were admitted into the Emergency Department and Neurology Department of Tianshui Hospital of Chinese Medicine from May 2022 to June 2025 were assigned to the treatment group and the control group through the random number table method ， with 30 cases in each group. The control group received intravenous infusion of Tirofiban injection in addition to conventional treatment； the treatment group received acupuncture at the main points Baihui （DU 20）， Fengchi （GB 20）， and Tianzhu （BL 10） and at auxiliary points Quchi （LI 11）， Hegu （LI 4）， Shousanli （LI 10）， Zusanli （ST 36）， Houxi （SI 3）， Jianliao （SJ 14）， Yanglingquan （GB 34）， Xuanzhong （GB 39）， Lianquan （RN 23）， and Zhaohai （KI 6） based on the treatment in the control group. The course of treatment was two weeks. The clinical effects and safety in both groups were evaluated；the scores of National Institute of Health Stroke Scale （NIHSS），Modified Barthel Index （MBI）， and Fugl-Meyer Assessment Scale （FMA）， blood platelet count （BPC）， mean platelet volume （MPV）， platelet distribution width （PDW）， platelet aggregation rate （PAR）， and the mean blood flow velocity of anterior cerebral artery （ACA），middle cerebral artery （MCA），and posterior cerebral artery （PCA） before and after treatment were observed. Results： The total effective rate was 83.33% （25/30） in the treatment group and 66.67%（ 20/30） in the control group，the difference being significant（ P＜0.05）. After treatment，the NIHSS scores of the two groups were decreased when compared with those before treatment （P＜0.05），and the MBI and FMA scores were increased when compared with those before treatment （P＜0.05）； the NIHSS score of the treatment group was lower than that of the control group （P＜0.05）， and the MBI and FMA scores were higher than those of the control group （P＜0.05）. After treatment，the levels of PDW，MPV，PAR，and BPC in the two groups were decreased when compared with those before treatment （P＜0.05），and the levels of the four indexes in the treatment group were lower than those in the control group （P＜0.05）. After treatment，the mean blood flow velocity of ACA，MCA，and PCA in the two groups were increased when compared with those before treatment （P＜0.05），and the mean blood flow velocity of MCA， PCA， and ACA 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% （3/30） in the treatment group and 16.67% （5/30） in the control group，with no statistically significant difference between the two groups （P＞0.05）. Conclusion：The therapy of acupuncture combined with Tirofiban is significantly effective in treating hyperacute ischemic stroke beyond the time window，which can greatly regulate patients' platelet function and cerebral blood flow with great safety.