Abstract: Sanqi in Chinese herbal medicine is the root and rhizoma of Panax notoginseng (Burk.) F.H.Chen, which belongs to genus Panax in the Araliaceae family and is widely used as a tonic medicine in the traditional Chinese medicine. The main active constituents of sanqi are Panax notoginseng saponins, including ginsenoside Rg1, Rb1 and notoginsenoside R1. A wide variety of pharmaceutical applications of Panax notoginseng saponins have been reported in the regulation of blood circulation system, cardiovascular system and nervous system. Ischemic stroke, the most common form of stroke, leads to a high risk of morbidity and disability, which evolves serious medical, social and economic problems. Ischemia-reperfusion injury is the most important part in the progress of ischemic stroke. Abnormal energy metabolism, disturbance of the ion metabolism, free radical injury, inflammatory reactions all participate in the complex pathological mechanisms of ischemiareperfusion injury. Over the past few decades, substantial studies demonstrated that Panax notoginseng saponins possessed a significant protective effect on ischemia-reperfusion injury. However, little is known about the underlying mechanisms of the protective effects. In order to develop a new medicine from Panax notoginseng, we provide a review of the major literatures on the pharmaceutical actions and molecular mechanisms of Panax notoginseng and Panax notoginseng saponins in the protection of ischemia-reperfusion injury.