Objective To investigate the effects of intravenous thrombolytic therapy with alteplase on neurological function，inflammation and oxidative stress in patients with acute cerebral infarction（ACI）. Methods? A total of 64 patients with acute cerebral infarction admitted to Chang'an Hospital from April 2017 to May 2020 were selected as the research objects，and they were randomly divided into control group and observation group with 32 cases in each group. The control group was treated with aspirin and urokinase，and the observation group was treated with alteplase intravenous thrombolysis. The levels of nerve function，inflammatory factors and oxidative stress related factors were compared between the two groups. Results? The scores of National Institute of Health Stroke Scale（NIHSS），modified Rankin's Scale（mRS）and TNF，IL-1β，Hypersensitivity C-Reactive Protein in the observation group were significantly lower than those in the control group（P＜0.05）；superoxide dismutation in the observation group Enzymes（SOD）and glutathione peroxidase were higher than those of the control group，and oxidized low-density lipoprotein and malondialdehyde were significantly lower than those of the control group. The difference was statistically significant（P＜0.05）. Conclusion? Intravenous thrombolytic therapy with alteplase can improve the neurological function of patients with ACI，control the level of inflammatory factors and oxidative stress reaction.