About one third of stroke patients have renal dysfunction. Effect of renal dysfunction on outcome of intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) has not been determined in Asia using a large-scale study. This study aimed to investigate the impact of renal dysfunction on the outcome of IVT in AIS patients in Asia. The study included 1000 patients with AIS who underwent IVT and had renal dysfunction. The primary outcome was the modified Rankin Scale (mRS) score at 3 months after IVT. The secondary outcomes were the National Institutes of Health Stroke Scale (NIHSS) score at 24 hours after IVT and the Barthel Index (BI) score at 3 months after IVT. The results showed that patients with renal dysfunction had a higher mRS score at 3 months after IVT compared to those without renal dysfunction. The NIHSS score at 24 hours after IVT was also higher in patients with renal dysfunction. However, the BI score at 3 months after IVT was not significantly different between the two groups. The study suggests that renal dysfunction may modify the effect of IVT on the outcome of AIS in Asia. Further studies are needed to confirm these findings and to explore the underlying mechanisms.