To observe the effect of Huoxue Huayu decoction on N-terminal brain natriuretic peptide (NT-proBNT), serum inflammatory factor, nerve function and peptide(copeptin) level in patients with acute cerebral infarction. Methods: A total of 114 patients with acute cerebral infarction were randomly divided into observation group(n=57) and control group(n=57) according to the random number table. The control group was treated with routine treatment, while the observation group was treated with Huoxue Huayu decoction except for the medication of the control group. The total duration of the two groups was 14d. Compare and analyze the NT-proBNT, copeptin, interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs CRP) and tumor necrosis factor alpha (TNF alpha), neural function defect degree (NIHSS), ability of daily life (ADL) score, therapeutic efficacy and side effects of the two groups. Results: The levels of serum NT-proBNT and copeptin in the two groups were lower than before(P<0.05). The serum level of NT-proBNT and copeptin in the observation group was lower than that of the control group (P<0.05). Serum hs-CRP, TNF-, IL-6 of the two groups has lowered(P<0.05). After treatment, IL-6, TNF-, hs-CRP in the observation group was lower than that of control group (P<0.05). NIHSS score has decreased(P<0.05) in both groups, and ADL score has increased(P<0.05). The NIHSS score in the observation group was lower than that of the control group (P<0.05), while the ADL score was higher than that of the control group (P<0.05).The total effective rate in the observation group(68.42%) was higher than that of the control group(89.47%)(P<0.05). No side effect was observed in the two groups during the treatment. Conclusion: Huoxue Huayu decoction can reduce the level of NT-proBNT, copeptin and serum inflammatory factors in patients with acute cerebral infarction, and thus improving neurological function and the daily life ability of patients.