To investigate the correlation between blood glucoseat admission and time from symptom onset to treatment (ONT) with prognosis after intravenous thrombolytic therapy in patients with acute ischemic stroke. Methods: A total of 107 acute ischemic stroke patients who received intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) were retrospectively analyzed. They were divided into the effective group (43 cases) and the ineffective group (64 cases) according to National Institute of Health Stroke Scale (NIHSS) scores 24 h after intravenous thrombolytic therapy. Clinical data of the two groups were compared, and factors correlated with prognosis were analyzed. Results: The 90 d modified Rankin Scale (mRS) score of the effective group was lower than that of the ineffective group (P<0.05). The ONT and blood glucose at admission were both lower in the effective group than those in the ineffective group (P<0.05). Multiple Logistic regression analysis indicated ONT (OR=0.992, P=0.025) and blood glucose level at admission (OR=0.746, P=0.022) were factors correlated with prognosis． Conclusion: Implementing intravenous thrombolytic therapy as soon as possible and controlling blood sugar levels may be important steps in improving prognosis in patients with acute ischemic stroke