〔Abstract〕 Objective To study the curative effect and safety of edaravone combined with butylphenol in the treatment of acute ischemic stroke. Methods A total of 92 patients with acute ischemic stroke diagnosed and treated in the Pingdingshan First People's Hospital from January 2020 to January 2022 were selected and divided into an observation group and a control group by random number table method, with 46 cases in each group. The observation group was treated with edaravone combined with butylphenol, and the control group was treated with butylphenol. Efficacy, complications, National Institutes of Health stroke scale (NIHSS), modified barthel index (MBI), Fugl-Meyer assessment scale (FMA) score, S100 calcium binding protein B (S100B), myelin basic protein (MBP) and Tau protein levels were compared between the two groups. Results The total effective rate of the observation group was higher than that of the control group, the difference was statistically significant (P < 0.05). After treatment, the NIHSS score of the observation group was lower than that of the control group, and the MBI and FMA scores were higher than those of the control group, with statistical significance (P < 0.05). After treatment, the levels of S100B and MBP in the observation group were lower than those in the control group, and the levels of Tau protein were higher than that in the control group, with statistical significance (P < 0.05). There was no significant difference in the incidence of liver and kidney function injury, digestive tract reaction, rash, neuropsychiatric symptoms and abnormal blood cells between the two groups (P > 0.05). Conclusion Edaravone combined with butylphenol can improve the neurological function and the level of brain injury markers in patients with acute ischemic stroke, and its efficacy and safety are higher than edaravone.