The occurrence, progression, and clinical prognosis of ischemic stroke are influenced by various factors, among which a sudden increase in blood pressure during the acute phase is a typical clinical manifestation and is associated with poor prognosis. Therefore, implementing effective blood pressure management strategies during the acute phase of ischemic stroke is crucial for controlling the condition and improving the prognosis. Based on the current state of research, this article mainly reviews several aspects, including the characteristics of blood pressure changes during the acute phase of ischemic stroke, the potential adverse effects of elevated blood pressure on patients, blood pressure management strategies for intravenous thrombolysis and endovascular treatment, and the selection of appropriate methods for reducing blood pressure.