Stroke has become a major health issue worldwide, bringing a heavy burden to patients, families, and society. Effective reperfusion therapy can significantly improve the outcomes of patients with acute ischemic stroke (AIS). The secondary prevention guidelines in various countries recommend reducing stroke risk by strictly controlling blood pressure. With the widespread application of 24-hour ambulatory blood pressure monitoring, the study of blood pressure variability (BPV) has gradually become a hot topic in the field of stroke prevention and treatment. However, the impact of BPV on the outcomes of patients with AIS receiving reperfusion therapy remains controversial. This article mainly reviews the concept and the related parameters of BPV, as well as the relationship and possible mechanisms between BPV and the outcomes of patients with AIS receiving reperfusion therapy.