Objective To investigate the clinical effect of aspirin combined with clopidogrel in the treatment of acute cerebral infarction with type 2 diabetes mellitus and the complication of bleeding. Methods The clinical data of 107 patients with acute cerebral infarction and type 2 diabetes mellitus who were treated in our department were collected. The patients were divided into experimental group with 58 patients and control group with 49 patients. The patients in the experimental group were given aspirin combined with clopidogrel, while those in the control group were given aspirin alone. The National Institutes of Health Stroke Scale (NIHSS) score was recorded on admission and after 2 weeks of treatment; the modified Rankin Scale (mRS) score, recurrence of cerebral infarction, and drug-induced bleeding were recorded after 3 and 6 months of continuous administration. Results After 2 weeks of treatment, the experimental group had a significantly better recovery of neurological function than the control group (P<0.05). After 3 months of treatment, compared with the control group, the experimental group had significantly lower recurrence rate of cerebral infarction and disability rate (P=0.046 and P=0.037) and a significantly better recovery of neurological function (P=0.03); there was no significant difference in bleeding between the two groups (P=0.699). After 6 months of treatment, the experimental group had significantly lower recurrence rate of cerebral infarction and disability rate than the control group (P=0.037 and P=0.039). Compared with the control group, the experimental group had a significant increase in bleeding (P=0.038), mainly a small amount of gastrointestinal bleeding. Conclusions The short-term application of aspirin combined with clopidogrel can effectively reduce the recurrence rate of cerebral infarction and promote the recovery of neurological function in patients with acute cerebral infarction and type 2 diabetes mellitus. Long-term use of aspirin combined with clopidogrel has a clinical significance in the prevention and treatment of cerebral infarction with type 2 diabetes mellitus, but it can increase the risk of gastrointestinal bleeding.