Objective:To investigate effect of blood glucose on early neurological deterioration (END) and outcome after intravenous thrombolysis in patients with acute ischemic stroke (AIS).Methods:Patients with AIS treated with intravenous thrombolysis in the Department of Neurology, the Second Affiliated Hospital of Xuzhou Medical University from June 2020 to December 2021 were collected retrospectively. Demographic and baseline clinical data of the patients were collected. END was defined as an increase of ≥2 in reassessing the maximum score of the National Institutes of Health Stroke Scale within 72 h after admission compared with the baseline. Poor outcome was defined as the modified Rankin Scale score ≥3 at 3 months after onset. Multivariate logistic regression analysis was used to evaluate the independent correlation between various blood glucose indicators (including admission blood glucose [ABG], admission hyperglycemia [AH], fasting blood glucose [FBG] on the next day after admission, and stress hyperglycemia ratio [SHR]) and END and poor outcome after intravenous thrombolysis. Results:A total of 319 patients with AIS were enrolled, including 126 (39.5%) had AH, 67 (21.0%) had END, and 85 (26.6%) had poor outcomes at 3 months after onset. Multivariate logistic regression analysis showed that after adjusting for confounding factors, ABG (odds ratio [ OR] 1.188, 95% confidence interval [ CI] 1.105-1.278; P<0.001), AH ( OR 4.246, 95% CI 2.291-7.869; P<0.001), FBG ( OR 1.272, 95% CI 1.139-1.420; P<0.001), and SHR ( OR 2.559, 95% CI 1.192-5.664; P=0.016) were independently associated with END, while all blood glucose indicators were not independently associated with the poor outcomes at 3 months after onset. Conclusion:Higher blood glucose is independently associated with END after intravenous thrombolysis in patients with AIS, but not with the outcomes at 3 months after onset.