Abstract: Objective This study aimed to investigate the clinical efficacy and safety of the combined therapy of Wenjing Tongluo Decoction and butylphthalide in patients with acute cerebral infarction of Qi deficiency and blood stasis type. Methods A total of 152 patients diagnosed with acute cerebral infarction of Qi deficiency and blood stasis type, admitted to Guangde Traditional Chinese Medicine Hospital in Anhui Province between February 2022 and January 2025, were selected as study subjects. According to the random number table method, the patients were divided into a control group (n= 76, treated with butylphthalide alone) and an observation group (n= 76, treated with Wenjing Tongluo Decoction combined with butylphthalide). Neurological function, self-care ability, Traditional Chinese Medicine syndrome scores, serum indicators, and the incidence of adverse reactions were compared between the two groups. Results After 2 and 4 weeks of treatment, the scores for symptoms such as deviation of the mouth and tongue, numbness on one side of the body, stiff tongue with slurred speech, limb weakness, shortness of breath and lack of desire to speak, pale complexion, spontaneous sweating, and limb swelling all decreased significantly compared with those before treatment in both groups (P < 0.05). Moreover, the above-mentioned symptom scores in the observation group were lower than those in the control group at both 2 and 4 weeks of treatment (P < 0.05). After 2 and 4 weeks of treatment, the National Institutes of Health Stroke Scale (NIHSS) scores of the observation group were lower than those of the control group, while the Activities of Daily Living (ADL) scores were higher (P < 0.05). Compared with the control group, the observation group showed more significant reductions in serum D-dimer (D-D), homocysteine (Hcy), and C-reactive protein (CRP) levels after 2 and 4 weeks of treatment (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion In patients with acute cerebral infarction of Qi deficiency and blood stasis type, the combination therapy of Wenjing Tongluo Decoction and butylphthalide can promote neurological recovery, reduce serum levels of Hcy, D-D, and CRP, alleviate clinical symptoms, and demonstrate a favorable safety profile.