【Abstract】 Objective To explore the application value of combined examination in the diagnosis and treatment of patients with acute cerebral infarction. Methods A retrospective analysis was conducted on 80 patients with cerebral infarction admitted to Fangcheng County People’s Hospital from January 2023 to April 2024. Taking comprehensive clinical diagnosis results as the gold standard, the detection rate of acute cerebral infarction by magnetic resonance imaging (MRI) and susceptibility weighted imaging (SWI) were analyzed. The consistency of combined detection and clinical comprehensive diagnosis, as well as the diagnostic efficacy of combined examination for acute cerebral infarction were evaluated. Results Based on the gold standard of clinical comprehensive diagnosis results, among the 80 patients, 68 cases were diagnosed with acute cerebral infarction, with the detection rate was 68/80 (85.00%), and 12 cases were diagnosed with non-acute cerebral infarction, with the detection rate was 12/80 (15.00%). The diagnostic criteria of MRI and clinical comprehensive diagnosis were in good agreement (kappa=0.501). The diagnostic criteria of MRI combined with SWI were in good agreement with clinical comprehensive diagnosis results (kappa=0.826). The specificity (83.33%), sensitivity (92.64%), positive predictive value (96.92%), negative predictive value (67.67%) and diagnostic accuracy (91.25%) of combined MRI and SWI in the diagnosis of acute cerebral infarction were higher than those of MRI and SWI alone (P ＜ 0.05). The area under ROC curve of MRI combined with SWI examination was 0.821, and its sensitivity and specificity were statistically significant compared with that of single detection (P ＜ 0.05). Conclusion Both MRI examination and SWI examination have high diagnostic value for acute cerebral infarction, but the combined use of MRI and SWI provides superior sensitivity, specificity and accuracy in diagnosing acute cerebral infarction.