Objective:To study the effect of Tongqiao Huoxue Decoction combined with butylphthalide soft capsules on acute ischemic stroke and its effect on serum vascular endothelial growth factor (VEGF). Methods:There are 76 patients with acute ischemic stroke (Acute Ischemic Stroke, AIS), including 38 cases in the control group and the observation group. All patients were treated with conventional treatment methods for this disease. On this basis, the control group was given butylphthalide soft capsules orally, 0.2g/time, 3 times a day, and the observation group was given Tongqiaohuoxue Decoction on the basis of oral butylphthalide soft capsules. One dose a day, two times in the morning and evening. All patients were treated for 20 days as a course of treatment. The clinical efficacy of the two groups of patients were compared, the collateral circulation rate before and after treatment, NIHSS, MoCA and MMSE, hemorheology (plasma viscosity, fibrinogen, whole blood high and low shear viscosity), VEGF levels and the occurrence of adverse reactions. Results:The effective rate of the two groups was 92.1％ in the observation group and 73.7％ in the control group, which was significantly different (P<0.05). The collateral circulation patency rate was 86.8％ in the observation group and 57.9％ in the control group, which was significantly different (P<0.05). After treatment, the MoCA, MMSE scores and VEGF levels of the observation group were significantly higher than those before the treatment and the control group, with significant differences (P<0.05). The NIHSS score and hemorheology were improved compared with those before the treatment and the control group. There are significant differences (P<0.05). Conclusion:Tongqiao Huoxue Decoction combined with butylphthalide soft capsules can significantly improve collateral circulation, hemorheology, neurological and cognitive functions in patients with acute ischemic stroke. The mechanism may be related to the increase ofVEGF levels and the promotion of neovascularization.