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To study the effect of cilostazol after thrombolytic therapy with recombinant human tissue plasminogen activator (rt-PA) in patients with acute cerebral infarction and its effect on Serum Platelet lysosomal membrane protein (CD63), α Role of granule membrane glycoprotein (CD62P) and platelet activating factor (PAF). 90 patients with acute cerebral infarction treated in our hospital from February 2020 to February 2022, they were randomly divided into observation group and control group, with 45 cases in each group. Both groups were treated with rt-PA thrombolytic therapy, the control group was treated with aspirin after thrombolytic therapy, and the observation group was treated with cilostazol on the basis of the control group, and were treated continuously for 14 days. The clinical efficacy, changes of serum CD62p, CD63, PAF, whole blood viscosity, plasma viscosity, erythrocyte specific volume (HCT), NIHSS score, Barthel scale (Barthel Index) score, and incidence of bleeding events were compared between the two groups. The total effective rate of the observation group was 91.11%, which was higher than 73.33% of the control group, with statistical significance (P<0.05); the serum CD62p, CD63 and PAF in observation group were lower than those in control group, with statistical significance (P<0.05); the whole blood viscosity, plasma viscosity and HCT in observation group were lower than those of control group, with statistical significance (P<0.05); the NIHSS score in observation group was lower than control group, and Barthel index was higher than control group, with statistical significance (P<0.05); comparison of the total incidence of bleeding events between the two groups, with statistical significance (P＞0.05). Cilostazol have a significant effect on acute cerebral infarction patients after rt-PA thrombolytic therapy, which can effectively reduce the expression of serum CD62p, CD63 and PAF and improve platelet function, with good safety and worthy of clinical promotion. [ABSTRACT FROM AUTHOR]