Aim To explore the effect of short term intensive insulin therapy on stress-induced hyperglycemia and outcomes in patients with acute stroke. Methods 216 patients with acute stroke and stress-induced hyperglycemia were randomly divided into normal therapy group(n=108) and short term intensive insulin therapy group(n=108).The patients were maintained with normal glycemia(4.0～6.1 mmol/L).After seven days,the results were observed. Results Neural function defect level of intensive insulin therapy group was lowered compared with normal therapy group.The cure rate and obviows recovery rate in intensive insuline therapy group was higher than normal therapy group,and its bad change rate was lower(P<0.05). Conclusions Short term intensive insulin therapy can increase the curing rate and reduce mortality of patients with acute stroke and stress-induced hyperglycemia.The therapy has the important clinical meaning to improve prognosis.