Objective: To investigate the effects of intravenous thrombolysis therapy with alteplase on neurological function, coagulation function and serum inflammatory factors in patients with acute cerebral infarction. Methods: A total of 96 patients with acute cerebral infarction admitted to our hospital from September 2017 to October 2019 were randomly divided into two groups, with 48 patients in each group. The control group (n=48) received routine treatment, and the observation group received intravenous thrombolysis therapy with alteplase on the basis of routine treatment. The neurological deficit score, prothrombin time(PT), activated partial thromboplastin time (APTT), tumor necrosis factor-a level (TNF-?), and high-sensitivity C-reactive protein (hs-CRP) were compared between the two groups after 15 days of treatment. Results: After treatment, NIHSS scores in both groups were lower than those before treatment; PT levels were increased, while APTT, TNF-? and hs-CRP levels were all decreased in both groups, and the changes in the observation group were greater than those in the control group, with statistically significant difference (P<0.05). Conclusions: Intravenous thrombolysis therapy with alteplase can improve the neurological function, coagulation function and serum levels of inflammatory factors in patients with acute cerebral infarction, which is worthy of clinical application.