To investigate the clinical effectiveness of the combined therapy of low-frequency repetitive transcranial magnetic stimulation (rTMS) and Tizanidine Hydrochloride in alleviating upper limb flexor spasticity symptoms in stroke patients. Methods: Clinical data were collected from 60 patients with upper limb flexor spasticity following stroke who received rehabilitation treatment at Beijing Boai Hospital from December 2020 to December 2023. These patients were divided into a control group and an observation group, with 30 patients in each group, according to different treatment methods. The control group was treated with oral Tizanidine Hydrochloride, while the observation group received a combination of Tizanidine Hydrochloride and low-frequency rTMS. Both groups of patients received secondary stroke prevention treatment and conventional rehabilitation training. Before treatment initiation and at the end of the 4th week of treatment, the Modified Ashworth Spasm Scale (MAS) was used to measure the degree of spasticity in the upper limb elbow flexors. The Upper Limb Fugl-Meyer Assessment (UFMA) was employed to evaluate the recovery of upper limb motor function, and the Modified Barthel Index (MBI) was applied to quantify the level of activities of daily living (ADL) in patients. Additionally, the occurrence of adverse reactions in both groups was recorded. Results: Prior to treatment, there were no statistically significant differences in MAS, UFMA, and MBI scores between the two groups (P>0.05). At the end of the 4th week of treatment, all three scores in both groups improved compared to those before treatment. The observation group showed superior performance to the control group in terms of the increase in UFMA and MBI scores and the decrease in MAS score, with all differences being statistically significant (P<0.05). Adverse reactions in both groups were infrequent and mild, with an incidence rate of 6.67% in each group, primarily manifested as drowsiness and dizziness. Conclusion: Compared to the use of Tizanidine Hydrochloride alone, the combination of low-frequency rTMS and Tizanidine Hydrochloride is effective in reducing the muscle tone of the upper limb flexors on the hemiplegic side, improving upper limb motor function, enhancing patients' quality of life, and demonstrating good safety in the treatment of upper limb flexor spasticity after stroke.