Objective: To observe the influence of edaravone dexborneol combined with ginkgo biloba extract (GBE) on cranial magnetic resonance imaging (MRI) examination results and prognosis in patients with acute ischemic stroke (AIS). Methods: Sixty patients with AIS admitted to the hospital from January 2023 to January 2025 were included. They were divided into routine group (routine treatment + edaravone dexborneol treatment, n=30) and GBE group (GBE treatment on the basis of routine group, n=30). The clinical efficacy as well as hematological indexes [plasma viscosity, whole blood low shear viscosity, homocysteine (Hcy), neutrophil (NE) percentage] and cranial MRI examination results [diffusion weighted imaging (DWI) high signal area range, apparent diffusion coefficient (ADC)] before and after treatment were compared between the two groups, and the incidence rates of adverse reactions and prognosis were observed. Results: After 14 days of treatment, the total effective rate in GBE group (96.67%) was higher than that in routine group (73.33%) (P<0.05). The plasma viscosity, whole blood low shear viscosity, Hcy and NE percentage in the two groups were significantly decreased (P<0.05), and the indexes in GBE group were more significant (P<0.05). The range of DWI high signal area in both groups was significantly reduced (P<0.05), and the range was more significant in GBE group (P<0.05). The ADC value in the two groups were significantly enhanced (P<0.05), and the GBE group had a more significant ADC value (P<0.05). There were no significant differences in the incidence rates of adverse reactions between GBE group and routine group (P>0.05). The good prognosis rate in GBE group was significantly higher than that in routine group (P<0.05). Conclusion: Edaravone dexborneol combined with GBE can significantly enhance the clinical efficacy in AIS patients, improve the hematological indexes and cranial MRI examination results, and significantly improve the prognosis, with good safety.