〔Abstract〕 Objective To investigate the efficacy of Solitaire stent mechanical thrombectomy combined with arterial thrombolysis with alteplase in the treatment of acute cerebral infarction. Methods A total of 120 patients with acute cerebral infarction who were admitted to Jiamusi Central Hospital from December 2017 to June 2021 were selected. Among them, 71 patients who underwent intravenous thrombolysis were defined as the venous group, and 49 patients who underwent Solitaire stent mechanical thrombectomy combined with alteplase arterial thrombolysis were defined as the arterial group. The vascular recanalization of patients in the arterial group after treatment was analyzed, and the scores of National Institutes of Health stroke scale (NIHSS) and modified Rankin scale (mRS), therapeutic efficacy and safety were compared between the two groups. Results The total effective rate of the arterial group was 95.92 %, which was higher than 80.28 % of the venous group, and the difference was statistically significant (P < 0.05). The NIHSS score of the arterial group was lower than that of the venous group at all time after treatment, and the difference was statistically significant (P < 0.05). mRS scores in the arterial group were lower than those in the venous group after 3 and 6 months of treatment, and the differences were statistically significant (P < 0.05). The incidence of bleeding was 6.12 % in the arterial group and 12.68 % in the venous group, and there was no statistical significance between the two groups (P > 0.05). Conclusion Solitaire stent mechanical thrombectomy combined with arterial thrombolysis with alteplase can achieve a relatively high vascular recanalization rate and improve postoperative neurological impairment in patients with acute cerebral infarction.