Objective To explore the prognostic influence of combination therapy with mild hypothermia and edaravone for acute cerebral infarction.Methods Two hundred and forty-five cases of diagnosed as acute cerebral infarction within 72 hours of onset were randomly divided into four groups according to the doctor visiting time.All the groups were treated with routine drugs.Combined therapy group (65 cases ) was treated with mild hypothermia combined with edaravone.Mild hypothermia group (59 cases ) was treated with local mild hypothermia.Edaravone group (58 cases) was treated with edaravone.Control group (63 cases) was only treated with routine drugs.The European Stroke Scale (ESS) score was performed before treatment,30 days after treatment.The activity of daily living (ADL) scores were evaluated before treatment,30 and 90 days after treatment.Results ESS scores were (45.22 ± 16.94),(46.88 ± 22.54),(47.13 ± 10.92),(46.94 ± 16.41 ) scores before treatment in combined therapy group,mild hypothermia group,edaravone group,control group respectively.ALD scores were (20.54 ± 14.65 ),(20.94 ± 10.93),(21.83 ± 14.71),(23.61 ± 18.91 ) scores before treatment in combined therapy group,mild hypothermia group,edaravone group,control group respectively.There were no differences in ESS and ADL scores before treatment among the groups.ADL scores were higher 30,90 days after treatment in combined therapy group [(59.57 ± 30.99),(74.46 ± 25.61) scores] than those in mild hypothermia group [(43.91 ±27.61),(58.13 ±26.62) scores) and control group [(34.58 ±27.75), (45.56 ±26.10) scores] (P ＜ 0.05) and higher after 90 days treatment than that in edaravone group [(62.83 ± 28.74) scores] (P ＜ 0.05 ).ESS scores 30 days after treatment in combined therapy group [(72.24 ± 14.54) scores] were higher than those in mild hypothermia group [(65.88 ± 17.76) scores],edaravone group [(65.27 ± 18.02) scores],control group [(60.62 ± 14.97) scores] (P ＜ 0.05 ).The effectiveness in combined therapy group [63.08％ (41/65)] was higher than that in mild hypothermia group [42.37％(25/59)],edaravone group [41.38％ (24/58)] and control group [23.81％ ( 15/63 )] ( P ＜ 0.05 ).The mortality rate in combined therapy group [9.23 ％ (6/65)] was lower than that in mild hypothermia group[10.17％(6/59)],edaravone group[12.07％(7/58 )] and control group [12.70％ (8/63)],but there was no significant difference (P ＞ 0.05 ).Conclusion The combination therapy with mild hypothermia and edaravone can improve the prognosis of acute cerebral infarction.