Objective To investigate the therapeutic effects of Shuxuening Injection combined with edaravone dexborneol in intravenous thrombolytic therapy for acute cerebral infarction.Methods A total of 152 patients with acute cerebral infarction treated at Zhangjiakou First Hospital between June 2022 and December 2023 were enrolled and randomly divided into a control group (n = 76) and a combination group (n = 76). All patients received standard thrombolytic therapy. The control group was additionally administered with edaravone dexborneol, while the combination group received Shuxuening Injection along with edaravone dexborneol. Clinical effectiveness, oxidative stress markers, serum inflammatory factors, hemodynamic parameters, and adverse reactions were compared between the two groups.Results The combination group exhibited significantly greater differences in pre- and post-treatment levels of NO, MDA, and ROS compared to the control group (P < 0.05). Similarly, the differences in T-AOC and SOD activity before and after treatment were higher in the combination group than in the control group (P < 0.05). The combination group also demonstrated greater reductions in TNF-α, hs-CRP, IL-6, and IL-8 levels (P < 0.05). Hemodynamically, the combination group showed superior improvements in Vm, PI, and RI (P < 0.05). However, the incidence of adverse reactions was higher in the combination group than that in the control group (P < 0.05).Conclusions The combination of Shuxuening Injection and edaravone dexborneol in intravenous thrombolytic therapy significantly enhances clinical outcomes, optimizes hemodynamics, mitigates oxidative stress and inflammation, and maintains a favorable safety profile, supporting its potential for broader clinical application.