Objective To evaluate the therapeutic effects of DL-3-n-butylphthalide (NBP) injection on acute cerebral infarction and its adverse reactions. Methods Seventy patients with acute cerebral infarction admitted in our hospital from September 2012 to November 2013 were randomly divided into standard treatment plus NBP (n＝35) and standard treatment (control, n＝35) groups. Before and in 14d after the treatment, the degree of neurological deficit was evaluated by National Institutes of Health Stroke Scale (NIHSS), daily living skills assessment were assessed by Barthel Index (BI) and modified Rankin Score (mRS), and adverse reactions were recorded. BI and mRS were also followed up in 90d after the treatment. Results In 14d after treatment, NIHSS were decreased in both NBP and control groups compared with pretreatment. The decrease in NIHSS was more significant in NBP group than in control group [NBP group: (13.60±4.26) vs (9.31±3.79); control group: (13.57±4.20) vs (11.23±4.06); P＝0.045]. No obvious change of BI was found in both 2 groups in 14 d after treatment. The BI at the follow-up of 90 d was significantly higher in NBP group than in control group [(NBP group: (54.57±24.17) vs (77.86±21.46); control group: (54.14±23.81) vs (67.0±23.30); P＝0.047)]. There was no significant change in mRS in both 2 groups after treatment for 14d. In 90d after the treatment, the decrease in mRS was more significant in NBP group than in control group [NBP group: (3.40±0.81) vs (2.80±0.96); control group: (3.49±0.82) vs (3.29±0.93); P＝0.035]. The incidence of adverse reactions was identical between the 2 groups. Conclusion NBP injection obviously improves neurological deficit resulting from acute cerebral infarction, and also improves 90-day outcome with sound safety.