In recent years，intravenous thrombolysis and intravascular therapy have brought major breakthroughs in the treatment of acute ischemic stroke(IS).However，vascular recanalization does not equate with successful tissue reperfusion.The authoritative journal Stroke has reported that 1/4 patients with successful vascular recanalization in IS have impaired tissue reperfusion，termed as no-reflow phenomenon，which is a potential therapeutic target for stroke.Of note，the lack of effective therapeutic strategies in Western medicine for no reflow after vascular recanalization has become one of the major bottlenecks constraining further improvement of clinical efficacy for IS.According to the theory of vessels and collaterals in traditional Chinese medicine(TCM)，we established the principle-method-prescription-medicine system for no reflow after vascular recanalization in IS.Specifically，on the basis of the major pathogenesis of qi deficiency and collateral obstruction，the therapeutic principle is tonifying qi and unblocking collaterals，which can be achieved by the representative prescriptions such as Buyang Huanwu Decoction and Tongxinluo Capsules.The system provides a novel TCM strategy for the prevention and treatment of no reflow after vascular recanalization in IS，which is of great significance in the clinical practice.