Objective To investigate the efficacy and safety of intravenous thrombolysis with different doses of recombinant tissue plasminogen activator(rt-PA)in patients with acute mild ischemic stroke(MIS).Methods Forty-four patients with acute MIS who received low-dose rt-PA(0.6 mg/kg,total dose≤60 mg)intravenous thrombolysis in Liuzhou People's Hospital from October 2018 to December 2021 were retrospectively included as low-dose group,and 62 patients with acute MIS who received standard-dose rt-PA(0.9 mg/kg,total dose≤90 mg)intravenous thrombolysis at the same time were included as standard-dose group.The therapeutic effects of the two groups were compared.Results There was no significant difference in clinical data between the two groups(P>0.05).There was no significant difference in the proportion of good prognosis[Modified Rankin Scale(mRS)score 0-2]between the two groups at 7 and 90 d after thrombolysis(P>0.05).There was no significant difference in the incidence of intracranial hemorrhage after thrombolysis between the two groups(P=0.397).Conclusion Intravenous thrombolysis therapy with rt-PA is safe and effective in patients with acute MIS,but low-dose thrombolysis therapy may be better.