Objective To compare the effect of arterial thombolysis with urokinase and intravenous thrombolysis with recombinant tissue plasminogen activator(rt-PA) in treatment of ischemic stroke.Methods One hundred patients with ischemic stroke were divided into intravenous thrombolysis (with rt-PA) group and arterial thrombolysis (with urokinase) group with 50 cases each by random digits table method.The thrombolytic recanalization rate,mortality rate and complications after treatment were observed and compared between two groups.Results The thrombolytic recanalization rate in intravenous thrombolysis (with rt-PA) group was higher than that in arterial thrombolysis (with urokinase) group [88.0％ (44/50) vs.66.0％ (33/50)],the complication rate in intravenous thrombolysis (with rt-PA) group was lower than that in arterial thrombolysis (with urokinase) group [6.0％ (3/50) vs.28.0％ (14/50)],and there was significant difference (P ＜ 0.05).There was no significant difference in mortality between two groups (P ＞ 0.05).There was no significant difference in the National Institutes of Health Stroke Scale (NIHSS) scores before treatment between two groups (P ＞ 0.05).The NIHSS scores 1,3,10,30 d after treatment were lower than those before treatment in two groups,and there were significant differences (P ＜ 0.05).There was no significant difference in NIHSS scores at different times and modified Rankin Scale 30 d after treatment between two groups (P＞ 0.05).Conclusions The efficacy of rt-PA in ischemic stroke patients is significantly better than that of the arterial thrombolysis with urokinase,with higher recanalization rate and fewer complications.It is safe and effective,and can be as the first choice for the treatment of ischemic stroke thrombolysis.