Serum uric acid plays dual role in physiological conditions. Hemorrhagic transformation(HT) is a common complication of acute ischemic stroke, which deteriorates the prognosis of ischemic stroke. The pathogenesis of hemorrhagic transformation is closely related to oxidative stress, inflammatory cascade, destruction of blood-brain barrier and alteplase thrombolysis. Many previous studies have shown that serum uric acid affects the occurrence and development of hemorrhagic transformation through a variety of ways. The aim of this article is to systematically review relevant research to improve the prognosis of hemorrhagic transformation.