Tanshinone IIA is one of the main active components of traditional Chinese medicine Salvia miltiorrhiza, which plays a pharmacological role, and has been proved by modern research to have the effect of anti ischemic stroke nerve damage. This article reviews the signal pathway and mechanism of tanshinone IIA on nerve damage after ischemic stroke in recent years through literature search, and finds that tanshinone IIA can regulate the activity and release of PI3K/Akt/mTOR, Nrf2, NF-κB. NLRP3, MAPK and other signal pathways, inhibit IL-6, IL-8 and TNF-α, up regulate the expression of neuron specific structural proteins, inhibit the activation and proliferation of astrocytes, play the role of anti neuroinflammation, oxidative stress, neuronal apoptosis, etc., thus reducing the damage of neurons after ischemic stroke, showing the mechanism characteristics of multi target, multi-channel and multi-level interaction. Based on this, this article briefly reviewed the neuroprotective mechanism of tanshinone IIA intervention on the above signal pathways after ischemic stroke, in order to provide reference for the clinical application and drug development of tanshinone IIA.