Objective: To investigate the effect of predictive nursing based on quality feedback theory on neurological function recovery in patients with acute ischemic stroke undergoing thrombolysis. Methods: A total of 100 patients with acute ischemic stroke undergoing intravenous thrombolysis were enrolled as research subjects and randomly assigned to either the experimental group (n=50, receiving quality feedback-based predictive nursing) or the control group (n=50, receiving conventional care) using simple random sampling. Before and 1 month after intervention, the National Institutes of Health Stroke Scale (NIHSS), Mini-Mental State Examination (MMSE) and Barthel Index were used to evaluate the neurological function, cognitive function and activities of daily living of the two groups, and the nursing satisfaction, nursing service quality and occurrence of nursing adverse events were compared between the two groups. Results: After intervention, NIHSS scores in both groups were lower than baseline(P<0.05), while MMSE scores and Barthel Index were higher than baseline(P<0.05). Moreover, NIHSS score in experimental group was lower than that in control group(P<0.05), while MMSE score and Barthel Index in experimental group were higher than those in control group (P<0.05). In addition, nursing service satisfaction and nursing service quality evaluation scores in experimental group were better than those in control group (P <0.05). The incidence of nursing adverse events in experimental group was lower than that in control group, but the difference was not statistically significant(P >0.05). Conclusion: Predictive nursing based on quality feedback theory can effectively promote neurological function recovery, improve cognitive function and activities of daily living, enhance nursing service quality and patient satisfaction, and has certain preventive effect on adverse events in patients with acute ischemic stroke undergoing thrombolysis.