Objective To investigate the association of oxidized low density lipoprotein (ox-LDL ) in the serum and lipoprotein associated phospholipase A2 (Lp-PLA2) levels with carotid atherosclerosis and neurologic impairment in patients with cerebral is-chemic stroke .Methods 135 patients with acute cerebral infarction (ACI group) and 150 cases inpatients (control group) from February 2015 to February 2017 in the Traditional Chinese Medicine Hosptical of Xinjiang Uygur Autonomous Region were select-ed to detect serum ox-LDL and Lp-PLA2 levels ,and serum ox-LDL ,Lp-PLA2 and other levels of blood lipid index were compared between ACI group and control group ;carotid artery ultrasonography was conducted ,ox-LDL and Lp-PLA2 levels of non plaque group ,stable plaque group and unstable plaque group were compared ;ox-LDL and Lp-PLA2 levels of mild ,moderate and severe pa-tients according to the score of the National Institutes of Health Stroke Scale (NIHSS) were compared .Results The serum ox-LDL and Lp-PLA2 levels of ACI group were higher than those in the control group ,and the difference was statistically significant (P<0 .01);serum ox-LDL ,Lp-PLA2 levels of stable plaque and unstable plaque were significantly higher than those of non plaque group (P<0 .05);serum ox-LDL ,Lp-PLA2 levels of unstable plaque were higher than those of the stable plaque group (P<0 .05);serum ox-LDL and Lp-PLA2 levels of moderate and severe patients determined by the NIHSS score were significantly higher than that of mild patients (P < 0 .05);serum ox-LDL and Lp-PLA2 levels of severe patients were significantly higher than that of moderate patients (P<0 .05) .Conclusion Serum ox-LDL and Lp-PLA2 levels of patients with cerebral ischemic stroke increased significantly compared with the normal people ,which reflects the severity of carotid atherosclerosis and neurologic impairment .ox-LDL and Lp-PLA2 levels can be used as a serum marker of acute ischemic cerebrovascular disease ,has certain clinical significance in evaluating the severity and prognosis of acute ischemic cerebrovascular disease .