Abstract：Objective To explore the efficacy and of edaravone in the treatment of elderly patients with acute cerebral infarction combined with moderate to severe obstructive sleep apnea hypopnea syndrome. Methods From June 2021 to June 2022, 88 elderly patients treated at our hospital for acute cerebral infarction combined with moderate to severe obstructive sleep apnea hypopnea syndrome were selected. They were randomly divided into a control group and a study group, with 44 patients in each group. The control group received continuous positive airway pressure therapy, while the study group received edaravone treatment in addition to the control group's therapy. Clinical efficacy and safety between the two groups were compared. Results After treatment, the study group showed significantly better outcomes in inflammatory and cell adhesion factors, intracranial arterial resistance index, neurological deficit, and activities of daily living scores compared to the control group, with statistically significant differences（t＝9.418, 6.827, 12.537, 19.152, 2.192, 5.681, 5.396, 4.491, 11.253, all P＜0.05）. The incidence of adverse reactions between the two groups showed no significant difference（χ2＝0.715, P＞0.05）.  Conclusion Combining edaravone with continuous positive airway pressure therapy in elderly patients with acute cerebral infarction and moderate to severe obstructive sleep apnea hypopnea syndrome can enhance clinical efficacy, improve patient’s independence in daily activities, and ensure the safety of clinical medication.