〔Abstract〕 Objective To explore the effect of butylphthalide on intravascular interventional therapy for perfusion injury after vascular recanalization in patients with acute ischemic stroke by reducing the NOD-like receptor heat protein domain related protein 3 (NLRP3) -mediated inflammatory response. Methods A retrospective analysis was performed on 140 patients with acute stroke treated by vascular interventional therapy in Anyang People's Hospital from June 2021 to June 2022, and they were divided into an observation group with 77 cases and a control group with 63 cases according to whether they took butylphthalide capsules orally after surgery. The National Institutes of Health stroke scale (NIHSS), Glasgow prognostic score (GOS) and vascular recanalization score were compared between the two groups before and 1 week after treatment, and the changes of peripheral blood NLRP3, interleukin-18 (IL-18) and IL-1β levels were compared between the two groups before and after treatment. Finally, treatment-related adverse reactions were analyzed in the two groups. Results After 1 week of treatment, NIHSS score decreased to varying degrees and GOS increased to varying degrees in the two groups. After 1 week of treatment, the NIHSS score of the observation group was higher than that of the control group, while the GOS was lower than that of the control group, the differences were statistically significant (P < 0.05). After 1 week of treatment, the vascular recanalization score of the observation group was (1.89 ± 0.25) points, higher than (1.43 ± 0.31) of the control group points, and the difference was statistically significant (P < 0.05). After 1 week of treatment, peripheral blood NLRP3, IL-18 and IL-1β were decreased in the two groups, and after 1 week of treatment, peripheral blood NLRP3, IL-18 and IL-1β in the observation group were lower than those in the control group, the differences were statistically significant (P < 0.05). There was no statistical significance in the occurrence of adverse reactions between the two groups (P > 0.05). Conclusion Butylphthalein can reduce perfusion injury after vascular interventional recanalization in patients with acute stroke, which may be related to reducing the inflammatory response mediated by NLRP3 inflammasome without increasing the therapeutic adverse reactions.