Abstract: ［Abstract］Objective To compare the efficacy between recombinant tissue plasminogen activator intravenous thrombolytic therapy and conventional antiplatelet therapy for acute cerebral infarction. Methods 120 patients with acute cerebral infarction in Tianjin Xiqing hospital from Jan 2013 to Feb 2015 were randomly divided into the control group （conventional antiplatelet therapy）and the observation group（recombinant tissue plasminogen activator intravenous thrombolytic therapy）according to the random number method，60 patients per group. The clinical efficacy， the improvement of nerve function defect and daily living ability on pre- and post-treatment in the two groups were compared according to the NIHSS score and Barthel index（BI）. Results Compared with the control group， the cure rate and total effective rate were significantly increased （P < 0.05），NIHSS scores were obviously reduced on post-treatment（P < 0.05），and BI scores were significantly increased on post-treatment in the observation group（P < 0.05）. Conclusion The recombinant tissue plasminogen activator intravenous thrombolytic therapy can significantly increase the clinical efficacy for acute cerebral infarction and improve the nerve function defect and daily living ability， which is worthy of clinical promotion.