Objective: To explore the impact of implementing a performance management model for cerebrovascular disease wards in municipal hospitals on the quality of treatment for patients with acute ischemic stroke, and to provide a reference for optimizing the management system of primary stroke centers. Methods: Eighty patients with acute ischemic stroke admitted to a municipal tertiary general hospital from July 2024 to July 2025 were selected as the study subjects. They were divided into a control group and an observation group, with 40 patients in each group, according to the implementation of the performance management model. The control group adopted the conventional management model of traditional cerebrovascular disease wards, while the observation group implemented a targeted performance management program for cerebrovascular disease wards. The differences in key treatment indicators and clinical prognosis between the two groups were compared. Results: The time from entry to needle (DNT) and time from entry to puncture (DPT) in the observation group were (38.26 ± 6.12) min and (68.41 ± 10.25) min, respectively, which were significantly shorter than those in the control group (56.14 ± 8.37) min and (92.73 ± 13.68) min, respectively (P < 0.05). The 7-day neurological function improvement rate in the observation group was 82.50%, and the 90-day good prognosis rate was 77.50%, both significantly higher than those in the control group (62.50% and 52.50%, respectively) (P < 0.05). The incidence of in-hospital adverse events in the observation group was 5.00%, significantly lower than that in the control group (20.00%) (P < 0.05). Conclusion: Implementing targeted performance management in the cerebrovascular disease wards of municipal hospitals can effectively shorten the critical time window for the treatment of acute stroke patients, improve the quality of treatment, and improve the clinical prognosis of patients. It is worth promoting and applying in primary stroke centers.