Objective: To analyze the acute stroke of hyperosmolar nonketotic diabetic coma in emergency treatment. Methods: From January 2014 to December 2016 in our hospital treatment of 92 cases of acute cerebral stroke complicated with hyperosmolar non ketotic diabetic coma patients, patients were admitted through the emergency treatment, analysis. Results: The major risk factors in 92 cases of respiratory infection, followed by urinary tract infection and gastrointestinal tract infection; all the patients recovery time was (21.206.82) h, osmotic pressure recovery time (32.6911.52), H (12.825.63) h time to correct shock; 92 cases of patients with blood glucose, serum sodium, serum potassium, blood hormone nitrogen and plasma colloid osmotic pressure after treatment were significantly better than before treatment, the difference was significant (<0.05); 22 cases of complications (8 cases, 7 cases of cerebral edema, 5 cases of heart failure, respiratory failure and multiple organ system failure in 2 cases, 18 cases died (19.57%), failure to rescue 13 cases, a total of 5 cases) misdiagnosis, 27 cases (29.35%). Conclusion: Acute stroke patients with hyperosmolar nonketotic diabetic coma death risk is very high, so early detection, accurate diagnosis, rapid assessment of the disease, correct water and electrolyte disorders as soon as possible, and actively improve the clinical manifestations in predisposing factors, improve the success rate of rescue