Stroke is characterized by high incidence, high mortality, and high disability rates. A series of functional impairments caused by stroke are the primary reasons for patient disability, making stroke rehabilitation a research hotspot in cerebrovascular disease recovery. The pathogenesis is characterized by underlying deficiency and manifesting excess, The occurrence of stroke is closely related to microcirculatory disorders and abnormal energy metabolism, while traditional Chinese medicine theory attributes its pathogenesis to “deficiency in origin and excess in manifestation”. For patients with ischemic stroke (IS) of the “qi deficiency and blood stasis”, rehabilitation strategies primarily focus on restoring neurological function, regulating neural reflexes, and promoting brain functional remodeling. Both traditional Chinese medicine and western medicine have shown favorable clinical efficacy in treating IS patients. Western medicine focusing on reperfusion after ischemia. However, its clinical outcomes are limited by the “no reflow” phenomenon after revascularization and controversies surrounding the efficacy of neuroprotective agents. Traditional Chinese medicine demonstrates unique advantages through tonifying qi and activating blood circulation, regulating gut microbiota-brain axis, and other holistic interventions. This article primarily discusses the clinical approaches for the synergistic intervention of traditional Chinese medicine and western medicine in “qi deficiency and blood stasis” type IS, systematically reviews the mechanisms and clinical evidences of both treatments, and explores synergistic enhancement pathways of them. By integrating clinical trials, basic research, and guideline consensus from the past five years, this review aims to provide new ideas and methods for the integrated traditional Chinese and western medicine therapy of “qi deficiency and blood stasis” type IS. It also seeks to offer a scientific basis for optimizing individualized treatment plans and advancing the internationalization of the integration traditional Chinese and western medicine.