Objective To systematically evaluate the efficacy and safety of Huoxue Huayu traditional Chinese medicine injection in the treatment of ischemic stroke. Methods PubMed, Cochrane, EMBASE, CNKI, Wanfang database and VIP were searched by computer, and RCT of traditional Chinese medicine injection of promoting blood circulation and removing blood stasis in the treatment of ischemic stroke was searched by computer. The searching time was from the establishment of database to April 15, 2020. After screening, the quality evaluation and data collection of the final included literature were carried out. Stata15.0 and gemtc14.3 were used for network meta analysis. Results 50 RCT literatures were included, involving 10 different interventions, a total of 5 778 patients with ischemic stroke. The order of improving clinical total effective rate: Danshen injection>Xuesaitong injection>Shuxuening Injection>Danhong injection>Breviscapine Injection >xueshutong injection>ginkgo leaf injection>Danshen Chuanxiong injection. To improve the order of neurological injury: Danshen Chuanxiong injection>Shuxuening Injection>xueshutong injection>Danshen injection>Xuesaitong injection> Danhong injection>Shuxuetong injection>ginkgo leaf injection>Breviscapine injection. The order of reducing plasma viscosity: Danhong injection>Xueshuantong injection>Danshen Chuanxiong injection>Shuxuetong injection>Xuesaitong injection>Breviscapine Injection>Shuxuening Injection>ginkgo leaf injection. To reduce the order of fibrinogen: Shuxuening Injection>Xuesaitong injection>Danhong injection>Xueshuantong injection>Danshen Chuanxiong injection> ginkgo leaf injection>Shuxuetong injection>Breviscapine injection. Conclusion Traditional Chinese medicine injection combined with routine medicine has some advantages in improving the clinical total effective rate, NIHSS score and plasma viscosity compared with western medicine alone, and the recommended treatment is Danshen Chuanxiong injection and Danhong injection. As few individual interventions have been included in the literature, this conclusion still needs to be verified by more high-quality research.