Objective To explore the efficacy of combination therapy of Ginkgo biloba injection and donepezil in the treatment of Alzheimer's disease (AD) based on cerebral hemodynamics and inflammatory factors. Methods A total of 90 patients with AD in Zhangjiakou Shalingzi Hospital from March 2020 to January 2022 were randomly divided into a control group ( 45 cases) and a study group (45 cases) . Both groups received the conventional symptomatic treatment. On this basis, the control group was given donepezil treatment, and the study group was given ginkgo leaf injection combined with donepezil treatment. The therapeutic effects, cerebral hemodynamic parameters [mean flow velocity (MFV) and pulsatility index (PI) of bilateral middle cerebral arteries (bilateral MCA) and basilar arteries (BA)], inflammatory factors [interleukin-6 (IL-6), tumor necrosis factorα (TNF-α), IL-1β], s100β protein, Aβ-amyloid 1-42 ( Aβ1-42), bradykinin (BK), cognitive function, activities of daily living, and adverse reactions were compared between the two groups. Results Compared with the control group (77.78%), the total effective rate of the study group (93.33%) was significantly improved (P < 0.05); 1, 3, and 6 months after the treatment, the MFV of BA and bilateral MCA in the study group was higher than that in the control group, while the PI of BA and bilateral MCA was lower than that in the control group (P < 0.05); The levels of serum TNF-α, IL-6, and IL-1β in the study group were lower than those in the control group 1, 3, and 6 months after the treatment (P < 0.05); 1, 3, and 6 months after the treatment, the levels of serum s100β protein, Aβ1-42, and BK in the study group were lower than those in the control group(P< 0.05); 1, 3, and 6 months after the treatment, the score of the mini-mental state examination scale (MMSE) in the study group was higher than that in the control group, while the scores of the AD assessment subscale cognitive scale (ADAS-cog) and activities of daily living scale (ADL) were lower than those in the control group (P < 0.05); The incidence of adverse reactions in the study group (13.33%) was not significantly different from that in the control group (8.89%) (P > 0.05). Conclusion The efficacy of ginkgo biloba injection combined with donepezil in the treatment of AD is significant, which may be achieved by improving cerebral hemodynamics, downregulating inflammatory factors, and regulating the levels of serum s100β protein, Aβ1-42, and BK. [ABSTRACT FROM AUTHOR]