Objective To explore the efficacy of tirofiban in patients with anterior and posterior circulation infarction caused by small artery occlusion (SAO).Methods Ninety-two patients with cerebral infarction caused by SAO admitted to Fuyang Hospital Affiliated to Anhui Medical University from October 2020 to February 2024 were included in the study. All patients received tirofiban treatment and were divided into the anterior circulation group (64 cases) and the posterior circulation group (28 cases) based on the location of vascular occlusion. The two groups were compared in terms of baseline characteristics, fasting blood glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol, National Institutes of Health Stroke Scale (NIHSS) scores, and modified Rankin Scale (mRS) scores.Results There were no statistically significant differences between the two groups in the proportions of patients with comorbid hypertension, diabetes mellitus, coronary heart disease, and hyperlipidemia, as well as in sex composition, age, smoking status, alcohol consumption, intravenous thrombolytic therapy, or fasting blood glucose, triglycerides, total cholesterol, and low-density lipoprotein cholesterol levels (P > 0.05). The difference in NIHSS scores before and after treatment in the anterior circulation group was higher than that in the posterior circulation group (P < 0.05). The mRS scores in the anterior circulation group were significantly lower than those in the posterior circulation group (P < 0.05).Conclusion Compared with patients with posterior circulation infarction caused by small artery occlusion, those with anterior circulation infarction caused by SAO receiving tirofiban treatment exhibit a significant reduction in NIHSS scores, alleviation of neurological impairment, and improved prognosis.