Background Thrombolysis with recombinant tissue plasminogen activator (rt-PA) has gained intational recognition,clinical outcomes following this thrombolytic therapy varied from patient to patient.Factors affecting clinical outcomes have not been well understood yet,so this retrospective case-control study aimed to investigate factors that may influence clinical outcomes of acute ischemic stroke treated with intravenous rt-PA.Methods One hundred and one patients with acute ischemic stroke who received intravenous rt-PA thrombolysis within 4.5 hours from disease onset were included.Patients were divided into good or poor outcome group according to modified Rankin Scale (mRS) score,good outcome group:mRS score of 0-1; poor outcome group:mRS of 2-6.Stroke characteristics were compared between the two groups.Factors for stroke outcomes were analyzed via univariate analysis and Logistic regression.Results Of the 101 patients studied,patients in good outcome group (n=55) were significantly younger than patients in poor outcome group (n=46,(62.82±14.25) vs.(68.81±9.85) years,P=0.029).Good outcome group had fewer patients with diabetic history (9.09％ vs.28.26％,P=0.012),fewer patients with leukoaraiosis (7.27％ vs.28.26％,P=0.005) and presented with lower blood glucose level ((5.72±1.76) vs.(6.72±1.32) mmol/L,P=0.012),lower systolic blood pressure level ((135.45±19.36) vs.(148.78±19.39) mmHg,P=0.003),lower baseline NIHSS score (12.02±5.26 vs.15.78±4.98,P=0.002) and shorter onset-to-treatment time (OTT) ((2.38±1.21) vs.(2.57±1.03) hours,P=0.044) than poor outcome group.Logistic regression analysis showed that absence of diabetic history (odds ratio (OR) 0.968 (95％ CI 0.941-0.996)),absence of leukoaraiosis (OR 0.835 (95％ CI 0.712-0.980)),lower baseline NIHSS score (OR 0.885 (95％ CI 0.793-0.989)),lower pre-thrombolysis systolic blood pressure (OR 0.962 (95％ CI 0.929-0.997)),and lower blood glucose level (OR 0.699 (95％ CI 0.491-0.994)) before thrombolysis were significantly associated with better outcome.Conclusion Patients with no history of diabetes,no leukoaraiosis,low blood glucose level,low systolic blood pressure level and low baseline NIHSS score before thrombolysis have a better outcome.