Abstract: Objective To investigate the effect of stroke nurses' participation in venous thrombolysis treatment process reengineering in patients with ischemic stroke and to propose effective process optimization measures. Methods From January 2018 to February 2020, 128 patients with ischemic stroke in Shaoxing People's Hospital were analyzed retrospectively. According to the time of admission, 64 patients with routine intravenous thrombolysis from January 2018 to January 2019 were included in the control group, and 64 patients with stroke nurses' participating in the reconstruction of intravenous thrombolysis from February 2019 to February 2020 were included in the study group. The therapeutic effects of the two groups were compared. Results The time from diagnosis to CT examination, from CT examination to thrombolysis and from diagnosis to thrombolysis were(12.05±6.23) min,(18.89±9.21) min, and(30.52±8.01) min in the study group, which were shorter than those from the control group(15.85±7.51) min,(28.62±8.75) min, and(45.62±9.51) min, respectively(t=3.115, 6.127, 9.715, all P<0.05). Two weeks after thrombolysis, the NIHSS and mRS scores of the study group were(9.21±3.52) points and(1.92±0.52) points, which were lower than those of the control group(10.54±4.24) points and(2.25±0.66) points, respectively(t=1.931, 3.142, P=0.028, 0.001). The incidence of venous thrombolytic complications in the study group was 1.56%, lower than that in the control group 12.50%(χ²=4.302, P=0.038). The mortality rate was 1.56% in study group and 4.69% in control group(χ²=0.258, P=0.611). The nursing satisfaction in the study group was 98.44%, higher than 85.94% in the control group(χ²=6.942, P=0.008). Conclusion The reconstruction of thrombolysis treatment process involved by stroke nurses can shorten the time of thrombolysis, improve the effect of treatment, reduce complications, improve the satisfaction of patients, and reduce the mortality.