Abstract: As one of the leading causes of mortality worldwide, stroke brings a great burden to the society. Hydroxysafflor yellow A is a major active water-soluble component of the flower of Carthamus tinctorius, which is an effective agent against ischemia stroke. Hydroxysafflor yellow A has wide-reaching biological activities, including anti-inflammation, antioxidation, anti-apoptosis, improving microcirculation, corrections of the impaired metabolic pathways, modulating the proliferation and migration of vascular smooth muscle cells and so on. Currently, there is an increasing number of related research devoted in investigating the effect of hydroxysafflor yellow A on treatment and prognosis of ischemia stroke through models including middle cerebral artery occlusion. This article aims at analyzing and concluding the information from relevant literatures, summing up the pharmacological mechanisms, treatment and prognosis of hydroxysafflor yellow A in ischemia stroke.