Objective To explore the application effect of functional electrical stimulation combined with exercise training in the treatment of senile stroke. Methods A total of 128 stroke patients with Zhongguancun Hospital from January 2021 to December 2023 were selected and divided into study group and the control group by random number table method. All patients received routine rehabilitation training, 64 patients in control group were trained by isokinetic muscle strength training on this basis, and functional electrical stimulation was implemented in the study group on the basis of control group. Both groups were treated for 4 weeks. The changes of nerve function, walking ability, limb function, neuron-specific enolase (NSE) level, cognitive function and daily living ability were observed before and 4 weeks after treatment in both groups. Results The National Institutes of Health Stroke Scale (NIHSS) scores of the study group were lower than those of the control group after treatment, and the MWS was faster than that of the control group (P<0.05). The Fugl-Meyer Assessment Scale (FMA) scores of the study group were higher than those of the control group after treatment (P<0.05). Serum neuron specific enolase (NSE) levels of the study group were lower than those of the control group, and Montreal Cognitive Assessment Scale (MoCA) scores were all higher than those of the control group (P<0.05). The Assessment of Daily Living (ADL) scores of the study group were higher than those of the control group after treatment (P<0.05). Conclusions Functional electrical stimulation combined with exercise training can promote the recovery of nerve function, walking ability and limb function, improve the level of NSE and cognitive function, and enhance the ability of daily living in elderly patients after stroke.