To study the clinical efficacy of treating spastic hemiplegia with functional stretching exercises (FSE) combined with baclofen tablets and repetitive transcranial magnetic stimulation (rTMS) in patients after stroke. Methods: A total of 177 cases of spastic hemiplegia after stroke were randomly divided into the control group (n=88) and the combined group (n=89). Patients in the control group were treated with baclofen tablets and rTMS, and patients in the combined group were treated with FSE combined with baclofen tablets and rTMS. The walking ability (10MWT and TUG scores), lower-limb functional activity (FMA and STREAM scores), lower-limb spasticity (MAS and CSI scores), balance ability (Mini-BES Test, BBS, and FTSST scores), neurological function (NIHSS score), and quality-of-life (FIM and BI scores) of the two groups were compared before and after treatment. The clinical efficacy of the treatment in each group was evaluated. Results: The walking ability, lower-limb functional activity, lower-limb spasticity, balance ability, neurological function, and quality-of-life in both groups were improved compared to those before treatment (P＜0.05). Furthermore, after treatment, all scores in the combined group were better than those in the control group (P＜ 0.05). The total effective rate of the combined group was significantly higher than that of the control group (P＜ 0.05). Conclusion: FSE combined with baclofen tablets and rTMS may be an effective way to improve walking ability, lower-limb functional activity, lower-limb spasticity, balance ability, neurological function, and quality of life in patients with hemiplegia after stroke.