Abstract: Objective To observe the clinical efficacy and safety of Tongqiao Huoxue Decoction in the treatment of patients with cognitive dysfunction after stroke, and to seek evidence-based evidence for its application in the treatment. Methods Sixty patients with post-stroke cognitive dysfunction admitted to the Rehabilitation Center of Henan University of Traditional Chinese Medicine from January 2017 to June 2018 were selected as the research subjects. According to the random number table, they were divided into experimental group and control group with 30 cases in each group. The control group was given only regular rehabilitation functional training, and the experimental group was given Tongqiao Huoxue Decoction addition and subtraction treatment based on the control group. Before and after 4 weeks of treatment, the Montreal Cognitive Assessment Scale(MoCA) and daily living ability(ADL) scores, vital signs and liver and kidney function indicators of the two groups were measured and compared. Results Before treatment, the baseline data such as MoCA and ADL scores were balanced and comparable. After 4 weeks of treatment, the MoCA and ADL scores of the two groups were improved compared with before treatment. The MoCA score of the experimental group was increased from 16.91±6.13 to 24.07±5.89, and that of the control group was increased from 16.73±6.15 to 20.14±6.21. The ADL scores of the experimental group was increased from 35.16±7.14 to 69.73±9.73, and that of the control group was increased from 35.72±9.22 to 51.26±8.46. Moreover, the increase in the experimental group was more significant, the differences were statistically significant(all P<0.05). Conclusion Tongqiao Huoxue Decoction is effective in treating post-stroke cognitive dysfunction, tonifying the deficiency and opening the orifices, which is worthy of further clinical promotion.