【Abstract】 Objective To analyze the treatment effect and prognostic analysis of ultraearly recombinant tissue plasminogen activator (rtPA) intravenous thrombolysisin patients with elderly cerebral infarction. Methods 82 patients with elderly cerebral infarction from January 2014 to August 2017 in our hospital was treated. According to different treatment methods, those patients were divided into control group and the research group, with 41 cases in each group. The control group was treated with ultraearly intravenous urokinase thrombolysis. The research group was treated with ultraearly rtPA intravenous thrombolysisin. The clinical curative effect, hemorheology, United States national institutes of health stroke scale (NIHSS) scores, Barthel index, complications and prognosis between the two groups were compared. Results Total effective rate in research group (7805%) was higher than control group (5610%) (P＜005). Before treatment, hemorheological indexes, NIHSS and Barthel index in two group had no differences (P＞005). After treatment, the blood rheological indexes and NIHSS in the two groups were significantly decreased, and the study group was lower than the control group (P＜005). The complication rate and mortality rate in research group were lower than control group (P＜005). Conclusion〓The ultraearly rtPA intravenous thrombolysisin is effective for patients with elderly cerebral infarction, can help the recovery of nerve function, high security, recommend a reasonable extension of the time window and expand the indications of intravenous thrombolysis.