Abstract：Objective To observe and analyze the clinical effect of butylphthalide in patients with acute perforating artery disease-type cerebral infarction. Methods A total of 160 patients with acute perforating artery disease-type cerebral infarction from January 2021 to January 2022 in our hospital were randomly divided into the routine treatment group and observation treatment group, with 80 patients in each. The conventional group received standard treatment, while the observation group received butylphthalide in addition to the standard treatment. Treatment outcomes, C-reactive protein（CRP）, serum homocysteine（Hcy）levels, neurological deficit scores, and daily living ability were compared between the groups. Results   After treatment, the total effective rate in the observation group was higher than in the conventional group, with statistically significant differences（χ2＝8.421, P＜0.05）. The observation group also showed better results in CRP, Hcy levels, neurological deficit scores, and daily living ability scores, with statistically significant differences in all measures （t＝14.295, 14.172, 24.374, 10.222, all P＜0.05）. Conclusion The use of butylphthalide in the treatment of patients with acute perforating artery disease-type cerebral infarction can effectively improve the CRP, Hcy indexes, neurological deficits and improve the quality of life of the patients. The overall therapeutic effect and prognosis are obvious improvement.