Objective: To analyze the effect of edaravone combined with breviscapine on cerebral blood flow, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in patients with acute cerebral infarction (ACI). Methods: A total of 60 patients with ACI treated in the hospital from March 2021 to December 2024 were selected and randomized to combination group and control group, with 30 cases in each group. The control group was treated with oral breviscapine tablets at 40 mg/time,3 times /day. On this basis, the combination group was treated with intravenous injection of edaravone at 30 mg/time, twice a day. After 3 d of continuous treatment, cerebral hemodynamic indicators in the two groups were detected using a cerebrovascular function monitoring device. A fully automated blood cell analyzer was used for detection, and blood NLR and PLR were calculated. Results: Peripheral resistance (Rv), blood NLR and PLR in the combination group were significantly lower than those in the control group (P<0.05). The mean blood flow velocity (Vmean) and cerebral blood flow (CBF) of the common carotid artery were significantly higher than those in the control group (P<0.05). There was no significant difference in the overall incidence of adverse reactions between the two groups (P>0.05). Conclusion: Edaravone combined with breviscapine can significantly improve cerebral blood flow, NLR, and PLR in patients with ACI.