Objective To analyze the effect of early intravenous thrombolytic therapy with alteplase on coagulation function and oxidative inflammation in patients with acute cerebral infarction. Methods: The total number of 80 patients with acute cerebral infarction admitted from September 2021 to July 2022 was selected as the research object. the two groups of patients. Results: Compared the coagulation compared with those before treatment, and the experimental group was the group with more significant increase (P<0.05); At the same time, compared wtumor necrosis factor and malondialdehyde were significantly improved compared with those before treatment. The group with better improvement was the experimental group, P<0.05; The neurological function scores of the two groups also decreased, and the experimental group decreased more significantly (P<0.05); The group with higher overall incidence of adverse reactions was the reference group (P<0.05). Conclusion: For the clinical treatment of patients with acute cerebral infarction, the early intravenous thrombolysis with alteplase can effectively improve the patient''s coagulation status and oxidative inflammatory reaction, improve the patient''s neurological function and reduce the possibility of complications.