Background: Herbal medicine was used routinely for acute ischeamic stroke in China, and there is an increasing number of registered titles, protocols and completed Cochrane systematic reviews about herbal medicine for acute stroke. Objectives: To provide an overview of the reviews focused on herbal medicine treatments for acute stroke. Methods: Cochrane systematic reviews regarding herbal medicine for acute stroke were searched. Results: There were three systematic reviews of different herbal medicines for acute ischaemic stroke. The herbal drugs were Danshen agents, Ginkgo biloba, and puerarin. Six trials were included in Danshen review, 14 in Ginkgo biloba review, and one in puerarin review. All the studies were of inferior quality in methodology. All the studies focused on the outcome of improvement in neurological deficit and showed a positive result. But due to the inferior quality, no convincing conclusions can be drawn. Follow-up was generally shorter than two months. Number of deaths or dependency was rarely reported in the trials. Conclusions: There were no convincing conclusions regarding herbal medicine for acute stroke because of inferior quality. Follow-up should be longer, at least two months after stroke. Disability should be evaluated as the main outcome measure. There is high need for higher quality of trials.