To observe the effects of different methods of vascular recanalization on patients with different causes of acute ischemic cerebrovascular disease. Methods: Eighty patients with acute ischemic stroke were divided according to treatment method into intravenous thrombolysis group (n=30), mechanical thrombectomy group (n=24), and combined treatment group (n=26). According to the TOAST classification criteria, each group was further divided into three groups: large atherosclerotic stroke type (type A), cardiogenic embolism type (type B), and other etiological type (type C). Patients were evaluated for status of blood vessel recanalization and bleeding after treatment. Prior to and 3 days after treatment, patients were evaluated with the National Institute of Health Stroke Scale (NIHSS). Patients were additionally evaluated prior to and 90 days after treatment with the Barthel Index (BI) and modified Rankin Scale (mRS). Results: After treatment, compared with the intravenous thrombolysis group and the mechanical thrombectomy group, NIHSS score of the combined treatment group was lower (P<0.05) and BI, mRS≤2 ratio, and vascular recanalization rate were higher (P< 0.05); hemorrhagic transformation rate of the combined treatment group was also higher (P<0.05). In the mechanical thrombectomy group, after treatment and compared with types A and C, type B showed lower NIHSS score (P<0.05) and higher BI, mRS≤2 ratio, and vascular recanalization rate (P<0.05). In patients with fibrillation associated with embolization, after treatment and compared with the intravenous thrombolysis group, NIHSS score of the mechanical thrombectomy group and combined treatment group was lower (P<0.05) and BI, mRS≤2 ratio, and vascular recanalization rate were higher (P<0.05). Hemorrhagic transformation rate in the combined treatment group was significantly higher than that in the mechanical thrombectomy group (P<0.05). Conclusion: In vascular recanalization therapy for acute ischemic cerebrovascular disease, intravenous thrombolysis is the best treatment for atherosclerotic cerebral infarction. Mechanical thrombectomy may be the best choice in patients with atrial fibrillation associated cerebral embolism. The effects of combined treatment may be better than that of single treatment, but the hemorrhagic transformation rate is significantly higher