Abstract: Cerebral ischemia-reperfusion injury, one of the main reasons for poor prognosis in patients with neurological diseases, is also an important cause of paralysis. It is more common in cardiac arrest, cerebral hemorrhage, cerebral infarction and stroke. The classical pathophysiological mechanisms mainly include oxidative stress, inflammatory response, calcium overload, nitric oxide and excitatory amino acid toxicity. With the development of medical technology, the treatment of cerebral ischemia-reperfusion injury has been improved. However, there is still an urgent need to explore more accurate and effective treatments. Mesenchymal stem cells (MSCs) are multipotential stem cells in bone marrow, muscle, fat and other tissues and organs. In recent years, MSCs have been explored in the treatment of various diseases because of their strong differentiation ability, secretion ability and good immunocompatibility. This paper describes the pathophysiological process of cerebral ischemia-reperfusion injury, and summarizes the role of MSCs in cerebral ischemia-reperfusion injury from the perspective of pathophysiological mechanism, in order to provide a new idea for the treatment of cerebral ischemia-reperfusion injury.