Objective To investigate the effects of Tongnaojing Capsules (TC) on neurological defects and insulin resistance (IR) in the rat model of IR complicated with focal cerebral ischemia (FCI). Methods The rat model of IR complicated with FCI was established by feeding the rats with high carbohydrate forage first and then, using electrocoagulation of the middle cerebral artery to induce FCI; the effects of TC on the score of neurological defects, blood sugar, serum insulin, C peptide, insulin antibodies and insulin sensitivity indexes (ISI) were observed during the experiment. Results During the establishment of the model, the symptoms of neurological defects showed in different degrees in some rats 4 weeks after they were fed with the high carbohydrate forage; the levels of serum insulin and blood sugar markedly increased ( P <0 01), the level of ISI remarkably decreased ( P <0 01), and the level of C peptide lowered while the level of insulin antibodies significantly increased ( P <0 01) 2 weeks after FCI was induced in the model rats; after the treatment of TC, all the above mentioned criteria were improved in different degrees ( P <0 001). Conclusions IR not only may cause FCI when being a possible independent risk factor, but also may play a role in the entire pathophysiological process of FCI as an FCI pathologic product; and TC can reverse IR and relieve the injuries caused by cerebral ischemia and restore the damaged neurological function to normal through reversing IR.