Objective To explore the efficacy of edaravone dexborneol combined with recombinant tissue plasminogen activator (rt-PA) in the treatment of acute cerebral infarction (ACI) and the influence on peripheral blood cystatin C (CysC) and retinol-binding protein (RBP) levels of patients. Methods 110 patients with ACI admitted from June 2019 to June 2023 in Hefei First People’ s Hospital were selected as the study subjects, and were randomly divided into study group (55 cases) and control group (55 cases) by coin tossing method. The control group was treated with rt-PA, and the study group was given edaravone dexborneol combined with rt-PA. The neurological function ［National Institutes of Health Stroke Scale (NIHSS)］, cognitive function ［Mini-Mental State Examination (MMSE)］, daily activity ability ［Modified Barthel Index (MBI)］, cerebral hemodynamic indicators ［bilateral internal carotid artery peak systolic blood flow velocity (Vs), diastolic blood flow velocity (Vd), mean blood flow velocity (Vm)］, peripheral blood oxidative stress ［superoxide dismutase (SOD), reactive oxygen species (ROS), malondialdehyde (MDA)］, inflammatory indicators ［C-reactive protein (CRP), serum matrix metalloproteinase-9 (MMP-9), serum matrix metalloproteinase-12 (MMP-12)］, peripheral blood CysC and RBP of the two groups were compared before treatment and after 7 days of treatment. Results After treatment, the NIHSS score, peripheral blood MDA, ROS, CRP, MMP-9, MMP-12 and CysC in both groups were lower than those before treatment, and the above indicators in study group were lower than those in control group during the same period (P＜0.05). The MMSE score, MBI score, peripheral blood SOD and RBP and bilateral internal carotid artery Vs, Vd and Vm were higher in both groups than those before treatment, and the indicators were higher in study group compared with those in control group (P＜0.05). ConclusionEdaravone dexborneol combined with rt-PA has good efficacy, and it can improve the neurological function, cognitive function and daily activity ability, accelerate the bilateral internal carotid artery blood flow velocity, relieve the oxidative stress response and inflammatory response, and correct the levels of peripheral blood CysC and RBP in the treatment of ACI, and it is conducive to promoting the prognosis and rehabilitation of patients