Objective　To investigate the safety and efficacy of intravenous thrombolysis with recombinant tissue plasminogen activator （rt-PA） in patients with acute ischemic stroke complicated with ischemic white matter lesions.MethodsOne hundred and ninety-nine patients with acute ischemic stroke complicated with ischemic white matter lesions were studied retrospectively.Ninety-nine patients received thrombolytic therapy （thrombolytic group） and 100 patients received routine antiplatelet aggregation therapy （control group）.The NIHSS scores of patients in each group at admission，24 hours and 7 days after treatment were accessed.Modified Rankin score 3 months after treatment，adverse events （symptomatic intracranial hemorrhage，asymptomatic intracranial hemorrhage）and stroke-related deaths within 3 months were recorded.Results　Compared with the control group，the levels of NIHSS in the thrombolytic group were significantly lower at 24 and 7 days（P<0.05）.The long- term prognosis of thrombolytic group was better than that of control group at 3 months （P<0.05）.Severn cases had of intracranial hemorrhage transformation after 24 h of thrombolysis (7.1%),in contrast,no patient had that in non-thrombolytic group （P<0.05）.However,there was no significant difference in the incidence of symptomatic intracranial hemorrhage and mortality.Conclusion　Merger of ischemic cerebral white matter lesions of AIS patients with venous thrombolysis treatment prognosis was obviously better.Thrombolysis group had increased bleeding risk,which will not lead to the occurrence of adverse reactions such as symptomatic intracranial bleeding,also does not increase mortality,in patients with venous thrombolysis treatment for merger of ischemic cerebral white matter lesions AIS patients have high security.