Background　Enhanced　external　counterpulsation　(EECP)　is　an　effective　method　for　treating　patients　with　cerebral　ischemic　stroke,　while　hemodynamics　is　the　major　contributing　factor　in　the　treatment　of　EECP.　Different　counterpulsation　modes　have　the　potential　to　lead　to　different　acute　and　long-term　hemodynamic　changes,　resulting　in　different　treatment　effects.　However,　various　questions　about　appropriate　counterpulsation　modes　for　optimizing　hemodynamic　effects　remain　unanswered　in　clinical　treatment.　Methods　A　zero-dimensional/three-dimensional　(0D/3D)　geometric　multiscale　model　of　the　cerebral　artery　was　established　to　obtain　acute　hemodynamic　indicators,　including　mean　arterial　pressure　(MAP)　and　cerebral　blood　flow　(CBF),　as　well　as　localized　hemodynamic　details　for　the　cerebral　artery,　which　includes　wall　shear　stress　(WSS)　and　oscillatory　shear　index　(OSI).　Counterpulsation　was　achieved　by　applying　pressure　on　calf,　thigh　and　buttock　modules　in　the　0D　model.　Different　counterpulsation　modes　including　various　pressure　amplitudes　and　pressurization　durations　were　applied　to　investigate　hemodynamic　responses,　which　impact　acute　and　long-term　treatment　effects.　Both　vascular　collapse　and　cerebral　autoregulation　were　considered　during　counterpulsation.　Results　Variations　of　pressure　amplitude　and　pressurization　duration　have　different　impacts　on　hemodynamic　effects　during　EECP　treatment.　There　were　small　differences　in　the　hemodynamics　when　similar　or　different　pressure　amplitudes　were　applied　to　calves,　thighs　and　buttocks.　When　increasing　pressure　amplitude　was　applied　to　the　three　body　parts,　MAP　and　CBF　improved　slightly.　When　pressure　amplitude　exceeded　200　mmHg,　hemodynamic　indicators　almost　never　changed,　demonstrating　consistency　with　clinical　data.　However,　hemodynamic　indicators　improved　significantly　with　increasing　pressurization　duration.　For　pressurization　durations　of　0.5,　0.6　and　0.7　s,　percentage　increases　for　MAP　during　counterpulsation　were　1.5%,　23.5%　and　39.0%,　for　CBF　were　1.2%,　23.4%　and　41.6%　and　for　time-averaged　WSS　were　0.2%,　43.5%　and　85.0%,　respectively.　Conclusions　When　EECP　was　applied　to　patients　with　cerebral　ischemic　stroke,　pressure　amplitude　applied　to　the　three　parts　may　remain　the　same.　Patients　may　not　gain　much　more　benefit　from　EECP　treatment　by　excessively　increasing　pressure　amplitude　above　200　mmHg.　However,　during　clinical　procedures,　pressurization　duration　could　be　increased　to　0.7　s　during　the　cardiac　circle　to　optimize　the　hemodynamics　for　possible　superior　treatment　outcomes.