Introduction: Stroke causes functional limitation, worsening status, frailty and demand for health care; Objective: To assess the quality of scientific evidence from a systematic review focused on the efficacy of stroke treatment. Objective: To assess the quality of scientific evidence from a systematic review focused on the efficacy of fibrinolytic fibrinolytic treatment in patients with ischemic stroke; Methodology: Systematic review of meta-analyses published between 2018 - 2023, in English and Spanish; Results: Fibrinolysis is fundamental in the reduction of disability secondary to the event. The use of tenecteplase leads to complete recanalization (38.5%); while alteplase 29%. A hemorrhagic risk of 3.05% for tenecteplase and 2.86% in alteplase, statistically alteplase, statistically significant (RR: 1.27 with 95% CI [1.02 - 1.57], p = 0.03). Therefore, tenecteplase is an effective option for treatment considering its minimal likelihood of producing bleeding; Conclusions: Both drugs are effective and adequate. However, tenecteplase ensures a lower risk of bleeding.