Objective To explore the effectiveness of edaravone dexborneol combined with tirofiban in patients with acute ischemic stroke.Methods The study included 106 patients with acute ischemic stroke admitted to the Handan Branch, Fengfeng General Hospital, North China Medical and Health Group from January 2022 to January 2024. Patients were divided into two groups by the random number table method, each with 53 individuals. The control group was treated with tirofiban alone, while the observation group received a combination of edaravone dexborneol and tirofiban. Both groups were treated for 14 days. Neurological function [National Institutes of Health Stroke Scale (NIHSS) score, Modified Rankin Scale (mRS) score], cognitive function [Montreal Cognitive Assessment (MoCA) score], cerebral blood flow parameters [mean flow velocity (Vm), peak systolic velocity (Vs), and pulsatility index (PI) of the middle cerebral artery], endothelial function [vascular endothelial growth factor (VEGF), nitric oxide (NO), endothelin-1 (ET-1) ], oxidative stress indicators [malondialdehyde (MDA), superoxide dismutase (SOD) ], and levels of neurotrophic factors were compared between the two groups before and after treatment.Results The differences of NIHSS, mRS, and MoCA scores before and after treatment were higher in the observation group than in the control group (P < 0.05). The differences of Vm, Vs and PI before and after treatment in the observation group were higher than those in the control group (P < 0.05). The differences of VEGF, NO and ET-1 levels before and after treatment in the observation group were higher than those in the control group (P < 0.05). The differences of MDA and SOD levels before and after treatment in the observation group were higher than those in the control group (P < 0.05). The differences of GDNF, BDNF and NGF levels before and after treatment in the observation group were also higher than those in the control group (P < 0.05).Conclusion Edaravone dexborneol combined with tirofiban enhances neurological function and cognitive performance while improving cerebral blood flow in patients with acute ischemic stroke.