For ischemic cerebrovascular disease, it is well known that early luxury perfusion is related to a good clinical outcome and single photon emission computed tomography(SPECT) has the potential for providing useful information about regional cerebral blood flow. We report one case of Rt. MCA infarction mainly treated by oriental medicine and revealed luxury perfusion without thrombolysis. In acute stage, neurological deficits of the patient were very severe. 99mTc-HMPAO SPECT images obtained 10days after the attack showed large perfusion defect in the Rt. MCA territory. We followed up 99mTc-HMPAO SPECT 40days after the ictus. Despite of the poor early perfusion, we found considerably improved perfusion and neurological improvement.