Objective To investigate the influence of combination of low-dose tirofiban and stent thrombectomy on collateral circulation and coagulation function in patients with acute cerebral infarction with large artery occlusion (ACI-LAO). Methods Totally 77 patients who received ACI-LAO treatment in the hospital were included from September 2020 to August 2023. According to the treatment regimens, the patients were divided into control group (37 cases) and combined group (40 cases). The control group adopted stent thrombectomy, whereas the combined group was treated with low-dose tirofiban combined with stent thrombectomy. The neurological function score (NIHSS), modified collateral score (mCS), incidence rate of hemorrhagic transformation, vascular recanalization rate, coagulation indexes ［fibrinogen (FIB), D-dimer, activated partial thromboplastin time (APTT), prothrombin time (PT)］ and thrombologram ［coagulation time (K value), coagulation velocity (α angle), maximum amplitude (MA value)］ were compared and analyzed in the two groups. Results After 2 weeks of surgery, the NIHSS score, FIB level, D-dimer level, APTT and PT in the two groups were reduced, and the reductions in the combined group were more obvious than those in the control group, and the mCS scores in both groups was increased after 2 weeks of surgery, and the combined group increased more significantly than the control group, and after 2 weeks of surgery, K value was declined significantly while α angle and MA value were risen significantly in both groups, and the improvements in combined group were better than those in control group (P<0.05). The total incidence rate of hemorrhagic transformation in the combined group was significantly lower while the total success rate of vascular recanalization was significantly higher compared to the control group (P<0.05).Conclusion Low-dose tirofiban combined with stent thrombectomy for ACI-LAO patients can effectively promote the recovery of collateral circulation, improve the neurological function and coagulation function, reduce the incidence rate of hemorrhagic transformation, and enhance the success rate of vascular recanalization