Objective <p>This paper aims to assess the clinical effectiveness of an Enhanced Recovery After Surgery (ERAS)-based care bundle in facilitating early rehabilitation in patients with acute ischemic stroke (AIS).</p> Methods <p>A total of 120 AIS patients were randomly assigned to either a control group (<i>n</i> = 60), receiving routine nursing care, or an experimental group (<i>n</i> = 60), which received additional ERAS-guided bundled care. Outcome measures included neurological function [NIH Stroke Scale (NIHSS), modified Rankin Scale (mRS)], limb strength (Lovett scale), language ability [Boston Diagnostic Aphasia Examination (BDAE)], swallowing function [Water Swallow Test (WST)], psychological status [Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA)], and quality of life [Stroke-Specific Quality of Life Scale (SS-QOL)]. Incidence of adverse events was also recorded.</p> Results <p>Post-intervention, NIHSS and mRS scores declined more markedly in the experimental group than in the control group (<i>P</i> &lt; 0.05). The experimental group had a higher number of patients with Lovett muscle strength grade 4, BDAE grades 4 and 5, and WST grade 1 compared to the control group (<i>P</i> &lt; 0.05). The HAMD and HAMA scores in the experimental group were lower than those in the control group (<i>P</i> &lt; 0.05). The experimental group also had lower adverse event rate compared to the control group (<i>P</i> &lt; 0.05).</p> Conclusion <p>An ERAS-based care bundle can significantly enhance early functional recovery, mitigate psychological distress, and reduce complications in AIS patients, supporting its clinical applicability in stroke rehabilitation.</p>