Objective：To investigate the clinical effect of mouse nerve growth factor （mNGF） combined with alteplase （rt-PA） in patients with acute cerebral infarction （ACI）. Methods： A total of 80 ACI patients were randomly divided into control group （40 cases） and observation group （40 cases）. The control group was treated with rt-PA thrombolytic therapy， and the observation group was treated with mNGF on the basis of rt-PA thrombolytic therapy. Both groups were treated for 14 days. Before and after treatment， the National Institutes of Health Stroke Scale （NIHSS） was used to evaluate the neurological function of the patients， the Barthel Index （BI） was used to evaluate the daily living ability of the patients， and the serum C-reactive protein （CRP）， erythrocyte sedimentation rate （ESR） and endothelin-1 （ET-1） and thromboxane A2 （TXA2） were detected. The differences in indicators and adverse reactions between the two groups were compared， and the incidence of adverse reactions in the two groups was counted. Results： Compared the total effective rate of the two groups， the observation group （95.00 %） was higher than the control group （80.00 %） ， and the difference was significant （P <0.05）. After treatment，compared with the control group， the NIHSS score was lower and the BI score was higher in the observation group （P <0.05）. The levels of serum CRP，ESR， ET-1 and TXA2 in the observation group were also significantly decreased （P <0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （P >0.05）. Conclusion： mNGF combined with rt-PA in the treatment of ACI can improve the curative effect， promote the recovery of neurological function， and reduce the levels of serum ET-1 and TXA2.