摘要Ischemic stroke(IS)is a severe cerebrovascular disease with a high incidence,mortality,and disability rate.The first-line treatment for IS is the use of recombinant tissue plasminogen activator(r-tPA).Regrettably,numerous patients encounter delays in treatment due to the narrow therapeutic window and the associated risk of hemorrhage.Traditional Chinese medicine(TCM)has exhibited distinct advan-tages in preventing and treating IS.TCM enhances cerebral microcirculation,alleviates neurological dis-orders,regulates energy metabolism,mitigates inflammation,reduces oxidative stress injuries,and inhibits apoptosis,thereby mitigating brain damage and preventing IS recurrence.This article summa-rizes the etiology,pathogenesis,therapeutic strategies,and relationship with modern biology of IS from the perspective of TCM,describes the advantages of TCM in the treatment of IS,and further reviews the pharmacodynamic characteristics and advantages of TCM in the acute and recovery phases of IS as well as in post-stroke complications.Additionally,it offers valuable insights and references for the clinical appli-cation of TCM in IS prevention and treatment,as well as for the development of novel drugs.