The pathophysiological process of ischemic stroke (IS) is highly complex. Current clinical treatments are limited by a narrow therapeutic time window and are inadequate for improving residual neurological dysfunction. Therefore, animal models have become essential tools for exploring the pathological mechanisms of this disease from both traditional Chinese medicine (TCM) and Western medicine perspectives,as well as for evaluating innovative therapeutic strategies. This review systematically outlines existing IS modeling methods and cutting-edge advances. It comparatively integrates the multi-layered pathogeneses in Western medicine, including excitotoxicity, oxidative stress, inflammatory responses, blood-brain barrier injury, ferroptosis, and PANoptosis, with the core TCM pathogenesis characterized by disorders of Qi and blood and functional imbalance caused by "wind, fire/heat, phlegm, blood stasis, and deficiency." Furthermore, this paper categorizes and compares the specific modeling techniques, evaluation indicators, and respective advantages and limitations of focal cerebral ischemia models, global cerebral ischemia models, and TCM disease-syndrome combined models, such as the Qi deficiency and blood stasis syndrome. Literature review suggests that, by exploring emerging cell death mechanisms like PANoptosis and introducing environmental stress or dietary interventions on the basis of ischemic modeling, specific TCM syndromes associated with IS can be preliminarily screened out and replicated. It provides a feasible approach for objectively elucidating the biological basis of TCM interventions involving multiple targets and pathways. Given that traditional single-disease models fail to fully capture the complexity and individual heterogeneity of the cerebral network microenvironment in clinical patients, future research on IS animal models should focus on the deep integration of TCM and Western medicine in pathogenesis. By leveraging multidisciplinary technologies, such as gene editing, high-resolution in vivo imaging, artificial intelligence-driven multi-omics analysis, and brain organoids, researchers can construct high-biomimetic, multi-dimensional models that closely mirror clinical scenarios, thereby effectively improving the success rate of translating innovative IS therapies from basic research to clinical application.