Objective To evaluate the clinical efficacy of butylphthalide in patients with cancer and ischemic stroke. Methods From June 2021 to June 2023， a prospective study was conducted on 86 patients with cancer and ischemic stroke admitted to the First Department of Neurology of Tangshan People's Hospital. The patients were divided into a butylphthalide group （n=43） and a control group （n=43） using random number table method. The control group received comprehensive treatment such as antithrombotic therapy， stable plaque therapy， symptomatic hypoglycemic and antihypertensive therapy according to the patient's condition. The butylphthalide group was treated with 100 ml butylphthalide and sodium chloride injection twice a day in addition to the control group. This study used the National Institute of Health Stroke Scale （NIHSS） to evaluate the neurological deficits in patients， and recorded related complications and evaluated prognosis. Detected the serum interleukin （IL）-6， IL-8， tumor necrosis factor-α （TNF-α） and soluble growth stimulation expressed gene 2 （sST2） factors in patients before treatment （upon admission） and after treatment （14 days after admission）， and calculate the difference to evaluate the effect of butylphthalide on inflammatory cytokine levels. Results After 24 hours， 7 days， and 14 days of treatment， the NIHSS score gradually decreased in patients of the butylphthalide group. Compared with the control group， the NIHSS score of patients in the butylphthalide group decreased 14 days after treatment ［6（4，10） vs 10（4，12） points］， and the difference was statistically significant （P ＜ 0.05）. There was no statistically significant difference in the incidence of intracranial hemorrhage between the patients in the butylphthalide group ［4.65%（2/43）］ and the control group ［2.33%（1/43）］（P ＞ 0.05）. Before and after the treatment， the difference levels of IL-6， IL-8， TNF-α and sST2 factors of patients in butylphthalide group were higher than those in the control group， and the differences were statistically significant （all P ＜ 0.05）. Conclusions For patients with cancer and ischemic stroke， butylphthalide can improve their neurological symptoms and reduce serum levels of IL-6， IL-8， TNF-α and sST2 factors without increasing the bleeding rate. It plays a positive role in improving the prognosis of patients with cancer and ischemic stroke.