Stroke has become a major disease endangering human health due to its high morbidity, high disability rate and high mortality. After the acute ischemic stroke, the blood-brain barrier is destroyed. A large number of immune cells enter the central nervous system and interact with the central immune cells, which is able to further amplify the inflammatory response and aggravate ischemic brain damage. The immune inflammatory response runs through the process of injury and repair of ischemic stroke, in which microglia plays an important role. This paper summarizes the mechanism of inflammatory injury in acute ischemic stroke, introduces the current clinical trials of interventions in stroke patients with immunomodulators, presents the problems faced by clinical trials of stroke, as well as looks forward to the future of stroke immunotherapy.