Abstract: Objective To explore the clinical efficacy and safety of intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) on patients with acute minor ischemic stroke (MIS). Methods One hundred and twelve patients who were diagnosed as MIS and admitted to our hospital within the time window of intravenous thrombolysis (4.5 h) from January 2015 to March 2017 were recruited in our study. These patients were then divided into three groups:intravenous thrombolysis within 0-3 h (n=14), intravenous thrombolysis within 3-4.5 h (n=32) and without intravenous thrombolysis (n=66). Patients in intravenous thrombolysis groups received the rt-PA therapy, and then were treated with dual anti-platelet therapy by aspirin and clopidogrel within 24 hours. Patients in without intravenous thrombolysis group received 300 mg clopidogrel therapy, and then were treated with dual anti-platelet therapy by aspirin and clopidogrel within 24 hours. All the patients had received NIHSS scoring at admission, and then received NIHSS and mRS scoring after 3 months as well. Results There was no statistical difference in the NIHSS score at admission, and in the NIHSS and mRS score at 3 months between three groups within 3 months, acute ischemic stroke recurred in 2 cases in intravenous thrombolysis group, and 12 cases in without intravenous thrombolysis group, with statistically significant difference. Conclusion The clinical efficacy of intravenous thrombolysis within 0-3 h and within 3-4.5 h has no difference. Compared with patients without receiving intravenous thrombolysis therapy, patients receiving intravenous thrombolysis therapy do not acquire better prognosis, but it may reduce the recurrence rate of ischemic stroke within 3 months.Keywords:minor ischemic stroke; intravenous thrombolysis; NIHSS score; acute ischemic stroke