To study the effect and mechanism of Buyang Huanwu Decoction on acute cerebral ischemia-reperfusion injury(CIRI) in rats.Methods:Thirty SD rats of SPF grade were randomly divided into a sham operation group，a model group，and a treatment group，with 10 rats in each group.The CIRI model was induced in rats of the model group and the treatment group.The rats in the treatment group received Buyang Huanwu Decoction by gavage for 14 consecutive days before modeling，and those in the sham operation group only underwent sham operation.The neurobehavioral score was evaluated，and water content in the brain and gene expression were measured.Results:Compared with the sham operation group，the model group showed increased neurobehavioral score，elevated water content in brain tissues，up-regulated mRNA expression levels of Bax and Caspase-3 in brain tissues，and down-regulated mRNA expression levels of Bcl-2，PI3K，and AKT.Compared with the model group，the treatment group showed decreased neurobehavioral score，reduced water content in brain tissues，down-regulated mRNA expression levels of Bax and Caspase-3 in brain tissues，and up-regulated expression levels of Bcl-2，PI3K，and AKT.Conclusion:Buyang Huanwu Decoction can alleviate acute CIRI，and its mechanism may be related to the inhibition of apoptosis mediated by the PI3K/AKT pathway.