摘要Stroke is the second leading cause of disability and mortality worldwide,imposing a substan-tial socioeconomic burden on individuals and healthcare systems.Annually,approximately 14 million people experience stroke,with ischemic stroke comprising nearly 85％of cases,of which 10％to 20％involve large vessel occlusions.Currently,recombinant tissue plasmino-gen activator(tPA)remains the only approved pharmacological intervention.However,its utility is limited due to a narrow therapeutic window and low recanalization rates,making it applicable to only a minority of patients.Therefore,there is an urgent need for novel thera-peutic strategies,including pharmacological advancements and combinatory treatments.Small-molecule natural medicines,particularly those derived from traditional Chinese herbs,have demonstrated significant therapeutic potential in ischemic stroke management.These compounds exert multiple neuroprotective effects,such as antioxidation,anti-inflammatory action,and inhibition of apoptosis,all of which are critical in mitigating stroke-induced cereb-ral damage.This review comprehensively examines the pathophysiology of acute ischemic stroke(AIS)and highlights the recent progress in the development of small-molecule natural medicines as promising therapeutic agents for cerebral ischemic stroke.