Objective To investigate the relationship between serum secreted phospholipase A2 (sPLA2) and the severity of the disease in cobra bite patients. Methods Fifty-two cobra bite patients admitted to our hospital from January 2015 to December 2015 were selected according to the inclusion and exclusion criteria. According to the degree of disease, patients were divided into the light and heavy risk groups. According to the degree of swelling of the affected limbs, patients were divided into the mild swelling group and moderate-severe swelling group. According to the time difference between visits, patients were divided into: visit time <8 h group and visit time ≥ 8 h group. Twenty healthy adult volunteers served as the control group. The levels of serum sPLA2, C reactive protein (CRP), D-dimer (DD), lactic acid (LAC) and peripheral blood leukocyte count (WBC) were measured and compared in different groups. Quantitative data were analyzed using t test and rank sum test. Results The levels of serum sPLA2 in the light and heavy risk group were statistically different from those in the control group (P<0.05), and were statistically significant between the light and heavy risk groups (P<0.01) and between the mild swelling group and moderate-severe swelling group (P<0.05). The serum sPLA2 levels in group A and group B were also significantly different from those in the control group (P<0.05). The level of sPLA2 was positively correlated with the level of LAC, DD and WBC, and the correlation coefficients were 0.3142, 0.2752 and 0.6534, respectively. Conclusions The higher the level of serum sPLA2, the more serious the patient's poisoning symptoms. It is of certain clinical value to evaluate the condition of cobra.