Background Cerebral infarction is often complicated with severe bulbar paralysis， and the late timing of traditional endotracheal intubation often results in long-term bulbar paralysis， thereby leading to the difficulties in treatment and poor prognosis.Objective To investigate the clinical effect of early endotracheal intubation combined with analgesia and sedation in the treatment of cerebral infarction with severe bulbar paralysis.Methods A total of 70 patients with cerebral infarction and severe bulbar paralysis who were admitted to our department from May 2020 to May 2021 were enrolled and divided into early intubation group and traditional intubation group， with 35 patients in each group， and all patients were given propofol and remifentanil for analgesia and sedation after intubation. The two groups were compared in terms of arterial blood gas parameters before and after intubation， disease severity before endotracheal intubation， prognostic evaluation at 3 months ［National Institutes of Health Stroke Scale （NIHSS） score， Glasgow Coma Scale （GCS） score， modified Rankin Scale （mRS） score， water swallow test score， acute ischemic stroke-associated pneumonia score （AIS-APS）］， the incidence rates of systemic complications （pulmonary infection， gastrointestinal bleeding， acute heart failure， and acute renal failure）， and clinical outcome and prognosis （time from disease onset to intubation， length of stay in the intensive care unit （ICU）， the number of patients unable to receive extubation for a long time， and the number of days from intubation to extubation for the patients who received extubation）.Results Both groups had significant improvements in arterial blood gas parameters after intubation （P<0.05）. Compared with the traditional intubation group， the early intubation group had significant reductions in the incidence rates of pulmonary infection， gastrointestinal bleeding， and acute heart failure （P<0.05） and a slight reduction in renal failure （P>0.05）. Compared with the traditional intubation group， the early intubation group had significantly shorter time from disease onset to intubation （P<0.05） and length of stay in the ICU （P<0.05）. There was no significant difference between the two groups in the number of patients who were unable to receive extubation for a long time （P>0.05）， and as for the patients who received extubation， the early intubation group had a significantly shorter time from intubation to extubation than the traditional intubation group （P<0.05）. Compared with the traditional intubation group at 3 months， the early intubation group had a significantly better prognosis based on NIHSS score， GCS score， mRS score， water swallow test score， and AIS-APS score （P<0.05）.Conclusions Early endotracheal intubation combined with analgesia and sedation can alleviate the severity of the disease before intubation， reduce the incidence rates of systemic complications， promote the recovery of the disease， and improve long-term prognosis.