Background: Ischemic stroke is a major cause of morbidity and mortality globally. Inflammation plays a central role in its pathophysiology, with biomarkers such as IL-6 and TNF-α serving as indicators of disease severity and prognosis. DLBS1033, a lumbrokinase-based oral supplement, has shown potential as an adjuvant therapy due to its anti-inflammatory and fibrinolytic properties.Objective: This study aimed to evaluate the effectiveness of DLBS1033 as an adjuvant therapy in reducing inflammatory biomarkers and improving clinical outcomes in acute ischemic stroke patients.Methods: A randomized controlled trial was conducted on 52 acute ischemic stroke patients treated at Dr. Moewardi General Hospital, Surakarta. Subjects were divided into two groups: treatment (DLBS1033) and control (placebo), administered for 28 days. Outcomes were measured through inflammatory biomarkers (IL-6, TNF-α, MMP-9), coagulation marker (D-dimer), Transcranial Doppler (TCD) indices, and clinical scores (NIHSS, Barthel Index).Results: Significant reductions in IL-6 and TNF-α levels were observed in the DLBS1033 group compared to controls at days 14 and 28 (p < 0> Conclusion: DLBS1033 as an adjuvant therapy demonstrates potential in improving inflammatory profiles and clinical outcomes in acute ischemic stroke without significant side effects. Further studies with longer follow-up are warranted to evaluate long-term vascular remodeling effects.