Objective: To investigate the effect of invasive arterial pressure monitoring nursing in patients with acute ischemic stroke. Methods: A retrospective analysis of 70 patients who underwent mechanical thrombectomy for acute ischemic stroke in Nanyang City Center Hospital of China from September 2019 to May 2021 was performed. The patients were randomly divided into 2 groups for a double-blind controlled study. The control group (n=35) received routine nursing, and the observation group (n=35) received additional invasive arterial pressure monitoring nursing. The Cerebral Hyperperfusion Syndrome (CHS) scale score, neurological recovery, and nursing satisfaction were compared between the 2 groups. Results: There was no significant difference in the National Institute of Health Stroke Scale (NIHSS) scores between the 2 groups before the intervention (P>0.05). After the intervention, the NIHSS scores of the observation group were significantly lower than those of the control group, and the difference was statistically significant (all P<0.05). Except for delirium and cerebral hemorrhage, the CHS scale scores in the observation group were significantly lower than those in the control group, and the difference was statistically significant (all P<0.05). The nursing satisfaction of the observation group was 88.57% (31/35), which was significantly higher than that of the control group with 60.00% (21/35), and the difference between the 2 groups was statistically significant (P<0.05). Conclusion: Invasive arterial pressure monitoring nursing can early detect postoperative hyperperfusion syndrome, and timely and effective intervention can improve neurological function and nursing satisfaction in patients with acute ischemic stroke.