With 7 million people in China, stroke is a major disease that affects the livelihood of the nation. Cerebrovascular disease is a disease with a high rate of disability. According to statistics, about 3/4 of the surviving patients with cerebrovascular disease lose their working ability to varying degrees. At present, the annual cost of treating cerebrovascular disease is more than 10 billion yuan, causing a heavy economic burden to the country and many families. Ischemic stroke is the predominant subtype of stroke in China. The most effective and definitive treatment for acute ischemic stroke (AIS) is rt-PA thrombolysis. It is recommended at the highest level in all national treatment guidelines. Thrombolytic therapy is currently the most important measure to restore blood flow. For patients within 3 h and 3-4.5 h of ischemic stroke onset, patients should be screened according to indications and given intravenous rt-PA thrombolysis as soon as possible. Thrombolytic therapy is the most effective drug for acute cerebral infarction, but there are still many problems with thrombolytic therapy in China. The main problems are low thrombolysis ratio, irregular thrombolysis, delay in pre-hospital and in-hospital time, and doubts of physicians and patients about the effect of thrombolysis treatment. In the United States, the average thrombolysis rate is about 8.5%, but in China, the Stroke Treatment Evaluation Collaborative Group surveyed 6416 patients with acute cerebral infarction in 62 hospitals, and only 1.9% of them were treated with thrombolysis, indicating that the thrombolysis rate is extremely low in most areas of China. Only 16% of patients with AIS in China were brought to the hospital within 3h of onset, and the in-hospital time from imaging to thrombolytic treatment was significantly longer than that in the United States or Canada, with an average of 85.5min, and many patients missed the opportunity for thrombolytic treatment. Neurology currently makes excessive use of neuroprotective agents and herbal medicines in the treatment of patients with acute cerebral infarction, while effective thrombolytic therapy is far from adequate. It is important for neurologists to know which drugs to use urgently, which to use slowly and which to prohibit, and to select drugs according to stroke treatment guidelines. Public education, shortened time to hospital, and timely thrombolysis will benefit more stroke patients.