To systematically evaluate the clinical efficacy and safety of Ginkgolide injection(GI)in the treatment of acute ischemic stroke(AIS).Methods:A total of 7 databases were systematically retrieved from inception to April 2020.Meta-analysis was performed on the clinical efficacy and safety of GI treatment of AIS by RevMan5.3 software.Finally，the GRADE system was adopted to evaluate the evidence quality of each outcome indicator.Results:A total of 20 studies were included.The results of meta-analysis showed that，in terms of the clinical efficiency，GI+Western medicine treatment(WMT)were superior to WMT(RRNIHSS=1.20,95%CI was 1.14 to 1.27，P<0.000 01; RRNDS=1.28，95%CI was 1.02 to 1.59)，P=0.03; RRclinical symptoms=1.26，95%CI was 1.03 to 1.55，P=0.03); GI+rt-PA+WMT were superior to rt-PA+WMT(RRNIHSS=1.24，95%CI was 1.10 to 1.41，P=0.000 6; RRmRS=1.27，95%CI was 1.10 to 1.46，P=0.000 6).In terms of the neurological function，GI+WMT was superior to WMT(MDNIHSS=-3.12,95%CI was -3.72 to -2.52，P<0.000 01; MDNDS=-2.93,95%CI was -3.67 to -2.19，P<0.000 01); GI+rt-PA+WMT was superior to rt-PA+WMT(MDNIHSS=-3.68,95%CI was -4.89 to -2.47，P<0.000 01; MDNDS=-10.58，95%CI was -12.01 to -9.15，P<0.000 01).In terms of the activity of daily living，GI+WMT were superior to WMT(MD=9.61，95%CI was 8.44 to 10.78，P<0.000 01); GI+rt-PA+WMT were superior to rt-PA+WMT(MD=8.80，95%CI was 5.80 to 11.80，P<0.000 01).In terms of adverse reaction rate，there was no statistical difference between GI+WMT and WMT alone(RR=0.63,95%CI was 0.28 to 1.43，P=0.27).Finally，evidence level evaluation showed that the level of evidence for clinical effectiveness and ability of daily living was intermediate，the level of evidence for neurological function score was low，and the strength of recommendation was weak.Conclusion:GI+Western medicine routine or GI+Alteplase+Western medicine routine can improve the clinical effectiveness，neurological function，and ability of daily living of AIS，and the incidence of adverse reactions is low.However，due to the low quality of the included literature and the low level of evidence，it is expected to carry out further large-scale clinical trials to further study the clinical efficacy and safety of GI treatment of AIS.