Objective: To investigate the clinical effect of Xingnaojing injection combined with craniocerebral hypothermia apparatus in the treatment of acute hemorrhagic stroke. Methods: Seventy-two patients with acute hemorrhagic stroke admitted to our hospital from March 2018 to September 2019 were randomly divided into two groups, with 36 cases in each group. The control group (n=36) was treated with craniocerebral hypothermia apparatus, and the observation group (n=36) was treated with Xingnaojing injection combined with craniocerebral hypothermia apparatus. The clinical efficacy, the National Institutes of Health Stroke Scale (NIHSS) score and the activity of daily living (MBI score) after 1 month of treatment were compared. Results: The effective rate of treatment in the observation group was higher than that in the control group (P < 0.05); NIHSS score was decreased in both groups (P < 0.05); MBI score was increased in both groups, and the change range of the observation group was greater than that of the control group, showing statistically significant differences (P < 0.05). Conclusion: Xingnaojing injection combined with craniocerebral hypothermia apparatus can improve the clinical efficacy, the neurological impairment and activity of daily living in the treatment of acute hemorrhagic stroke, which is worthy of clinical application.