Abstract: Objective To investigate the clinical efficacy of Buyang Huanwu decoction combined urokinase thrombolysis on acute cerebral infarction and its effect on serum VEGF and Ang-2. Methods A total of 106 patients with acute cerebral infarction treated in our hospital were randomly divided into two groups, with 53 cases in each group. The control group was given urokinase treatment, and the observation group was added Buyang Huanwu decoction based on the control group. The neurological deficits, hemorheology (whole blood viscosity, plasma viscosity, and erythrocyte sedimentation rate), serum VEGF and Ang-2 levels and clinical efficacy of two groups were compared. Results The total effective rate of observation group was 90.57%, which was significantly higher than that of the control group (67.92%, P<0.05). After treatment, the neurological deficit scores of two groups were significantly reduced (P<0.05), and the neurological deficit score of observation group was significantly lower than that of control group (P<0.05). After treatment, the whole blood viscosity, plasma viscosity and erythrocyte sedimentation rate levels were significantly decreased (P<0.05), and the index levels of observation group were significantly lower those of control group (P<0.05). After treatment, serum VEGF and Ang-2 levels of two groups were significantly increased (P<0.05), and VEGF and Ang-2 levels of observation group were significantly higher than those of control group (P<0.05). Conclusion Buyang Huanwu decoction combined urokinase thrombolysis could effectively treat acute cerebral infarction, significantly improve the nerve defects degree and microcirculation. And its mechanism might be related to its regulation of VEGF and Ang-2.