Objective To explore the effects of hypertension on the treatment of patients with acute ischemic stroke by recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis.MethodsPatients with acute ischemic stroke who were administrated intravenous rt-PA within 4.5 h after the onset were selected. The onset time was between February 2009 and June 2013. Modified Rankin Scale (mRS) was used to evaluate the recovery of neurological functions. Patients were divided into the good prognosis group (mRS scores were 0-1) and poor prognosis group (mRS scores were 2-6) according to the scores of mRS. General informations of patients were collected and compared between two group and risk factors were analyzed. Results The difference of the percentage of patients with hypertension of the good prognosis group (n=92) and poor prognosis group (n=83) was not statistically significant (66.30% vs 67.47%，P=0.870). The results of logistic multivariate regression analysis showed that hypertension was neither a risk factor of symptomatic intracranial hemorrhage (OR=0.453, 95%CI: 0.087-2.352, P=0.346) nor a influencing factor of the prognosis of thrombolysis (OR=1.014, 95%CI: 0.933-1.101, P=0.746). Conclusion The hypertension has no significant effect on the treatment of patients with acute ischemic stroke by rt-PA intravenous thrombolysis.