Aim To observe the effect of Xingling dispersible tablets on carotid atherosclerotic plaque, inflammatory factors and National Institutes of Health Stroke Scale (NIHSS) in patients with cerebral infarction, and to explore its therapeutic value. Methods 98 patients with cerebral infarction with carotid atherosclerotic plaque were randomly divided into control group and treatment group. On the basis of the control group, the treatment group was treated with Xingling dispersible tablets for 3 months. NIHSS, carotid atherosclerotic plaque area and carotid intima-media thickness (IMT) were observed before and after treatment, and the changes of serum C-reactive protein (CRP), homocysteine (Hcy) and interleukin-1β (IL-1β) were also measured. Results There was no significant difference before treatment in the NIHSS score, plaque area and IMT between the treatment group and the control group (P>0.05), but significantly decreased after treatment (P<0.001). After treatment, the NIHSS score, plaque area and IMT were lower in the treatment group than those in the control group (P<0.001). There was no significant difference in the levels of CRP, Hcy and IL-1β between the two groups before treatment (P>0.05), but significantly decreased after treatment (P<0.001). After treatment, CRP, Hcy and IL-1β in the treatment group were lower than those in the control group (P<0.001) . Conclusion Xingling dispersible tablets may inhibit the inflammation and delay the progress of carotid atherosclerosis, so as to improve the neurological deficit.