Aim To observe therapeutic effects and safety of Die-mai-ling injection (DMLI) on acute cerebral infarction. Methods 110 cases with acute cerebral infarction were randomly divided into three groups. 34 cases were given low molecular heparin (LMWH), 36 cases were given DMLI, and 40 cases were given DMLI + LMWH. Supporting treatment and heteropathy were employed in three groups. Neurological scales, therapeutic assessment, fibroprotein and the largest infarction area in CT of this attack were compared in three groups before and after treatment. Liver and renal function, blood routine and ECG were observed simultaneously. Results On the 14 th and 28 th day after treatment, neurological scales decreased significantly in the LMWH + DMLI group compared with LMWH group and DMLI group ( P< 0.05 or P< 0.01), there was no significant difference between LMWH group and DMLI group ( P> 0.05). On the 14th and 28 th day, the total effective rate of LMWH group, DMLI group and LMWH + DMLI group was 50% , 52.7%, 67.5% and 70.6% , 72% , 87.5%, LMWH+DMLI group was significantly higher than LMWH group and DMLI group ( P< 0.01), but no significant difference was found between LMWH group and DMLI group (P> 0.05). Rates of healing in LMWH + DMLI group was higher than LMWH group and DMLI group. The recovery ratio of DMLI group and LMWH + DMLI group was higer than that of LMWH group ( P< 0.01). There was no significant difference on the fibroprotein levels and the largest infarction area in the three groups before and after treatment ( P> 0.05). The treatment of DMLI was well toloranced, no adverse effects on liver and renal function and blood routine were observed. Conclusions DMLI is effective for the treatment of acute cerebral infarction, which curative effect is similar to LMWH. DMLI conjoined with LMWH in the treatment of acute cerebral infarction can improve effective rates significantly. The safety and tolerance of DMLI were comparatively good.