Abstract: Objective To learn the guidance effect of multi-mode MRI in intravenous thrombolysis of acute ischemic stroke;and to ensure the effectiveness and safety of intravenous thrombolytic therapy. Methods Total 102 patients with acute ischemic stroke in our hospital from August,2013 to August,2015 were selected.According to the results of multi-mode MRI test,the two groups were treated with intravenous thrombolytic therapy.The patients didn’t receive the intravenous thrombolytic therapy were chosen as the control group;while the patients receiving intravenous thrombolysis(alteplase) were assigned into the treatment group.The NIHSS score of two groups before and 6,24h and 7d after the treatment were compared,and the effect was evaluated at 7 d after treatment,and the adverse reactions were observed. Results According to the non-matching of PWI/DWI,55 cases in the treatment group were treated with intravenous thrombolysis,47 cases in the control group were not treated with intravenous thrombolysis.There were no significant differences in age,gender,smoking history,stroke history,and complication of the two groups(P>0.05).The NIHSS score before and 6,24 h and 7d after the treatment in the treatment group were 8.52±4.77,6.14±4.07 and 3.90±2.23,respectively,which were significantly less than those of the control group(t=1.775,2.875,2.024,P<0.05).The total efficiency of the treatment group was 83.64%(46/55),significantly higher than the control group(χ²=6.264,P<0.05).During the treatment,the incidence of adverse reactions in the control group was 10.64%(5/47),and in the treatment group was 12.73%,the differences between the two groups was not statistical significant(χ²=0.107,P>0.05). Conclusion Multi-mode MRI has a guiding role in intravenous thrombolysis for acute ischemic stroke,which can improve the therapeutic effect of intravenous thrombolysis,and had good clinical application value.