Carotid artery floating thrombus is a type of slender intravascular floating objects， which is frequently seen in the internal carotid artery. It is often caused by ruptured atherosclerotic plaques， which can cause severe vascular stenosis or multiple cerebral embolism in the downstream region due to the shedding of floating objects， with clinical manifestations of neurological deficits， and even cause malignant cerebral infarction of the middle cerebral artery and cerebral herniation， thus threatening the life. Its morbidity and recognition rate are low， and the causes are diverse. The treatment methods include internal carotid artery stenting， internal carotid endarterectomy， anticoagulation， and antiplatelet aggregation. However， there are no guidelines to follow. In this article， a case of cerebral infarction related to carotid artery floating thrombus was successfully treated with tirofiban to improve the understanding of cerebral infarction related to carotid artery floating thrombus and to provide new ideas for its treatment.Journal of International Neurology and Neurosurgery, 2021, 48(1): 99-102］