OBJECTIVE： To explore the therapeutic effect of early use of alprostadil and the effects on PTX-3， renal function and stability of carotid plaque in patients with acute cerebral infarction. METHODS： 93 patients with acute cerebral infarction in our hospital from Aug. 2011 to Aug. 2015 were selected， and divided into observation group （47 cases，2 case withdrew from the test and 45 cases completed the test） and control group （46 cases， 1 case withdrew from the test and 45 cases completed the test） by odd and even number of registration order. Control group was given Citicoline sodium injection 0.5 g + Extract of ginkgo biloba leaves injection 20 ml added into Sodium chloride injection （NS） 250 ml， ivgtt， qd； observation group was additionally given Alprostadil injection 20 μg added to NS 250 ml， ivgtt， qd. They were treated for 2 weeks. Clinical efficacy， and the differences of PTX-3， blood urea nitrogen （BUN）， serum creatinine （SCr）， 24 h urinary protein （Upro）， stability of carotid plaque before and after treatment， and the incidence of adverse reactions in 2 groups were observed. RESULTS： The total effective rate in observation group （91.1％） was higher than control group （73.3％）， the difference was statistically significant （P＜0.05）. There was no statistical significance in PTX-3，BUN，SCr， 24 h Upro between 2 groups before treatment （P＞0.05）. After treatment， PTX-3， BUN， SCr， 24 h Upro in 2 groups decreased， and observation group was lower than control group； stability of carotid plaque in observation group （100.0％） was higher than control group （64.0％）， the differences were no statistically significant （P＜0.05）. The adverse reactions in 2 groups relieved themselves with no special treatment， and with no statistical significant （P＞0.05）. CONCLUSIONS： The early use of alprostadil is effective for acate cerebral in farction， and can obviously reduce PTX-3 and improve renal functions， increase stability of carotid plaque with good safety.