Objective To evaluate the safety and efficacy of combined intra-arterial/intravenous thrombolysis versus intravenous thrombolysis for treatment of ACI in early stage. Methods The clinical data of pre-operation, postoperation and long-term follow-up of 68 patients with ACI were systematically reviewed. Results In combined thrombolysis group, there was significant difference in NIHSS score between postoperative and preoperative periods(P<0.05). In intravenous thrombolysis group, there was significant difference in NIHSS score between postoperative and preoperative periods (P<0.01). There was significant difference in postoperative NIHSS score between the two groups(P<0.05). There was significant difference in the rate of recanalization between the two groups(P<0.05). The difference in the rate of complications and mortality between the two groups was not significant(P>0.05). Conclusions The treatment of acute ischemic stroke with combined intra-arterial/ intravenous thrombolysis is better than .intravenous thrombolysis alone.