The treatment of acute ischemic stroke focuses on early diagnosis, treatment, and rehabilitation. Intravenous rt-PA is the only pharmacologic treatment approved by FDA. However, the therapeutic window of rt-PA is at most 4.5 hours after stroke, which limits the use of thrombolytic agent. Acupuncture and moxibustion therapy on acute ischemic stroke has been implemented for a long time in clinic. Studies on acupuncture intervening in acute/ultra-early ischemic stroke have revealed that acupuncture therapy could relieve the local circulatory disturbance of brain, recover the neurologic impairment, as well as eliminate the inflammatory damage. This article reviewed researches on the acupuncture involved in treating ultra-early ischemic stroke and the thrombolytic process, aiming to provide research strategy for the clinical application of traditional Chinese medicine, especially acupuncture, for acute ischemic stroke.