An-Gong Niu-Huang (AGNH) Pill is an emergency medication in traditional Chinese medicine (TCM). It has been widely used in the treatment of cerebrovascular diseases, meningitis, toxic encephalopathy, hematosepsis, and various types of fever and coma. Pharmacological studies on AGNH Pill revealed that it had the effects of anti-inflammation, cerebral circulation improvement, brain cell protection, brain injury-reducing, and post-injury brain edema improvement. All these effects became the research hotspots in its therapeutic mechanism study. This article summarized the Chinese medicine and modern medicine understanding of AGNH Pill, its clinical application and pharmacological mechanism in the treatment of acute cerebrovascular diseases in recent years, in order to provide references for clinical practice as well as new thinking and prospect for further research.