Nonagenarians with acute ischemic stroke tend to have a higher mortality and morbidity than younger patients. Tirofiban is a glycoprotein IIb/IIIa antagonist that has a therapeutic potential for ischemic stroke. Here, we provide a case report of a 93-year-old male patient with acute ischemic stroke. He presented with right-sided hemiparesis for 2 hours (National Institute of Health Stroke Scale, NIHSS = 23). Immediate treatment with endovascular tirofiban infusion achieved an improvement of intracranial blood flow and a progressively decreased NIHSS one day after admission (NIHSS = 16) and then seven days after admission (NIHSS = 7). After a follow-up of 90 days, the modified ranking score was 2. This case report suggests that endovascular application with tirofiban may be a favorable option for treating nonagenarians presenting with acute ischemic stroke and warrants further study.