Aim To investigate the effects of argatroban combined with edaravone on the recovery of neurological function and serum homocysteine (Hcy), CXC chemokine ligand 16 (CXCL16), and transforming growth factor-β1 (TGF-β1) in patients with posterior circulation acute cerebral infarction. Methods A total of 123 patients with acute cerebral infarction of the posterior circulation who were admitted to our hospital from January 2017 to March 2019 were selected as the research objects. According to the random number table, they were divided into combined treatment group, argatroban group, and edaravone group, with 41 cases in each group. On the basis of routine symptomatic treatment such as oxygen inhalation, infection prevention, anticoagulation, and plaque stabilization, the argatroban group was given argatroban, the edaravone group was given edaravone, and the combined treatment group was given argatroban and edaravone. After 14 days of treatment, comparing the therapeutic effect, hemodynamic index of the posterior circulation (post-cerebral artery, vertebral artery, basilar artery systolic peak blood flow velocity (Vs), resistance index (RI)), serum brain injury markers (neuron-specific enolase (NSE), polyamine oxidase (PAO), S-100β protein), serum inflammatory factors (Hcy, CXCL16, TGF-β1) levels, nerve function (NIHSS scores), daily living ability (ADL scores) before and after 14 days of treatment and adverse reactions of the three groups. Results The total effective rate of the combined treatment group was higher than that of argatroban group and the edaravone group. After 14 days of treatment, the NIHSS scores and ADL scores were better in combined treatment group than those of the argatroban group and edaravone group (P＜0.05). There was no significant difference in the incidence of adverse reactions among the three groups (P＞0.05). After 14 days of treatment, the Vs of the posterior cerebral artery, vertebral artery, and basilar artery of the three groups increased, and it was higher in combined treatment group than that in argatroban group and edaravone group, and the RI decreased, and it was lower in combined treatment group than that in argatroban group and edaravone group. After 14 days of treatment, serum NSE, PAO, and S-100β levels in the three groups decreased, and the combined treatment group decreased the most (P＜0.05). After 14 days of treatment, the levels of serum Hcy, CXCL16 and TGF-β1 in three groups decreased, they were lower in combined treatment group than those in argatroban group and edaravone group (P＜0.05).Conclusion Agatroban combined with edaravone is effective in the treatment of posterior circulation acute cerebral infarction, which can effectively improve the state of cerebral blood flow, suppress nerve damage, at the same time ease the body's inflammation, improve the patient's nerve function and daily life ability, and ensure the safety of treatment.