Objective Matrix metalloproteinase-10 (MMP-10) has been shown to be highly associated with atherosclerosis.Recent studies showed that levels of MMP-10 were elevated in infarcted tissues in acute ischemic stoke.However,serum levels of MMP-10 in patients with acute ischemic stroke have never been studied previously.This study aims to investigate the serum levels of MMP-10 in patients with acute ischemic stroke,and evaluate the association of serum levels of MMP-10 with stroke subtypes based on Trial of Org 10 172 in acute stroke treatment classifications,the severity of stroke,risk factors and carotid artery plaque.Methods The circulating levels of MMP-10 were measured by enzyme linked immunosorbent assay in 194 subjects,including 109 patients who were diagnosed as acute ischemic stroke in the Department of Neurology,Shengjing Hospital,China Medical University from April to December 2012,and the 85 healthy controls.Results Patients with acute ischemic stroke had higher serum levels of MMP-10 compared with healthy controls (6.59 (6.07,7.31) μg/L vs 5.16 (3.87,5.94) μg/L,Z =8.33,P ＜ 0.01).NIHSS score had positive correlation with serum levels of MMP-10 (r =0.204,P =0.037).Classified by risk factors,we compared the MMP-10 levels of subsets,and results displayed that statistically significant difference existed between dyslipidemia subset and non-dyslipidemia subset (Z =2.07,P =0.042).MMP-10 levels had positive correlation with serum levels of LDL-cholesterol (r =0.248,P =0.040),but negative correlation with thrombin-activatable fibrinolysis inhibitor (TAFI;r =-0.208,P =0.030).The subset with unstable plaques had higher MMP-10 levels than that with stable plaque (6.62 (6.13,7.36) μg/L) vs 6.10 (6.00,6.46) μg/L,Z =2.12,P =0.034),implying the relationship of MMP-10 and atherosclerosis.Conclusions Patients with acute ischemic stroke have higher serum levels of MMP-10 compared with the healthy controls,and MMP-10 levels have positive correlation with the severity of stroke.MMP-10 is associated with the subtypes of stroke classified by risk factors,and dyslipidemia subset has higher levels of MMP-10 than that of non-dyslipidemia subset.MMP-10 has positive correlation with LDL-cholesterol,but negative correlation with TAFI.MMP-10 may be involved in the process of formation and disruption of unstable plaques,which contribute to the stenosis of arteries and onset of acute ischemic stroke.