To select the relevant evidence on risk factors for intracranial hemorrhage (ICH) after thrombolysis with alteplase in patients with acute ischemic stroke (AIS) at home and abroad, and summarize the best evidence to provide a reference for reducing the risk of ICH after thrombolysis in patients with AIS. Meth? ods: Systematically search all evidence related to risk factors for ICH after alteplase thrombolysis in patients with AIS from domestic and foreign databases and official websites of relevant associations, including relevant guidelines, best clinical practice, expert consensus, summary of relevant evidence, systematic reviews, and various standards. The search time limit is January 1, 2010 - December 31, 2022. Then analyze and summarize the search results. Results: A total of 14 articles were included, including 6 guidelines, 1 expert consensus, 4 systematic reviews, and 3 scientific statements. Through the analysis of the 14 related literature according to the scientific steps, it was concluded that there are 8 factors related to ICH after alteplase thrombolysis in patients with AIS: time window, hypertension, hyperglycemia, admission National Institutes of Health Stroke Scale (NIHSS) score, atrial fibrillation, neutrophil percentage before thrombolysis, large area infarction, early ischemic changes on head CT before thrombolysis. Conclusion: This study summarizes the best evidence on risk factors related to ICH after alteplase thrombolysis in patients with AIS, providing an evidence-based basis for reducing its incidence.