Objective To develop a clinical pathway for early rehabilitation based on guidelines and to explore the effect of application in patients with ischemic stroke. Methods One hundred and twelve patients with ischemic stroke admitted from January to October 2019 were assigned into two groups. Patients admitted from January to May were served as the control group (n=56) and given routine early rehabilitation, while those admitted from June to October were treated as the intervention group (n=56) and received early rehabilitation following a clinical pathway, which was developed based on literature review and the best evidence regarding early rehabilitation. The NIH Stroke Scale (NIHSS), Fugl-Meyer Assessment (FMA), Barthel Index (BI) and patient satisfaction were used to evaluate the effect. Results The NIHSS score was significantly lower, whereas FMA score was significantly higher in the intervention group than those in the control group （P＜0.01 for all）.BI scores at discharge, 1, 3 and 6 months after discharge, as well as patient satisfaction at discharge in the intervention group were significantly higher compared with the control group （P＜0.01 for all）. Conclusion Implementation of guideline-based early rehabilitation clinical pathway in patients with ischemic stroke can effectively improve their limb function, performance in activities of daily living, and satisfaction with nursing care.