OBJECTIVE： To observe clinical effects and safety of sequential therapy of Ginkgo biloba extract preparation for elderly acute cerebral infarction， and to evaluate its pharmacoeconomics. METHODS： Totally 98 patients with acute cerebral infarction selected from neurology department of our hospital during Aug. 2014-Aug. 2015 were divided into control group and test group according to random number table， with 49 cases in each group. Both groups received routine therapy of antiplatelet aggregation， microcirculation improvement. Control group was additionally given Shuxuening injection 10 mL， ivgtt， qd， for consecutive 21 d. Test group was additionally given Shuxuening injection 10 mL， ivgtt， qd， for 7-10 d； and then given G. biloba tablet instead， 1 tablet， po ， tid， for 21 d in total. Clinical efficacies of 2 groups were compared as well as ESS score， ADL score， blood flow indexes and blood lipid indexes before and after treatment， and adverse drug reaction. Cost-minimization analysis was used for pharmacoeconomic evaluation. RESULTS： After treatment， total response rate of control group and test groups were 87.23％ and 83.33％， without statistical significance （P＞0.05）. Before treatment， there was no statistical significance in ESS score， ADL score， blood flow indexes and blood lipid indexes between 2 groups （P＞0.05）. After treatment， ESS score and ADL score of 2 groups were increased significantly， and whole blood viscosity， plasma viscosity， hematocrit， fibrinogen content， TC and TG were decreased significantly； there was statistical significance with before treatment （P＜0.05）； there was no statistical significance between 2 groups （P＞0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. The average cost of control group and test group were （7 060.9±234.8） yuan and （5 800.7±149.5） yuan， with statistical significance （P＜0.01）. CONCLUSIONS： The sequential therapy of G. biloba extract preparation is similar to intravenous dirpping in the treatment of elderly acute cerebral infarction in therapeutic efficacy and safety. The sequential therapy is better in economics field.