Ischemic stroke is a common cerebrovascular disease with significant neurological deficits caused by cerebral blood circulation disorders. Current medical treatments like thrombolytic therapy and interventional arterial thrombectomy are limited by strict time constraints and contraindications, leaving many patients without effective care options. Traditional Chinese Medicine (TCM) offers a complementary approach to treating ischemic stroke by addressing liver-yang wind, qi, blood imbalance, and brain disturbances. Zhengan Xifeng Decoction, a TCM formula, is believed to have a notable impact on ischemic stroke due to its ability to balance liver hyperactivity, promote blood flow, and nourish yin. This study aims to evaluate the efficacy and mechanisms of Zhengan Xifeng Decoction in treating ischemic stroke through a meta-analysis and network pharmacology analysis of randomized controlled trials. The results provide evidence-based medical support for the clinical application of Zhengan Xifeng Decoction.