Objective To explore the use of enzyme-linked immunosorbent assay(ELISA) to test the serological BP180NC16A-ELISA index in patients with bullous pemphigoid (BP) and investigate the relationship of this index with disease monitoring and therapeutic guidance.Methods The serological BP180NC16a-ELISA index at different times was examined in twenty BP patients with ELISA kit and monitor changes of pre-treatment BP180NC16a-ELISA index condition score and efficacy relationship..Results Twenty patients tested by ELISA had 19 cases of positive patients with positive rate of 95.0％ and one case negative with negative rate of 5.0％.After treatment,19 cases (19.60 ±4.63)d became stable,and condition score was (3.75 ± 1.37) points.After continued treatment (28.75 ± 6.11) d entering clinical remission,condition score was (2.25 ± 1.21)points.Compared with the score before treatment condition [(5.55 ± 1.61) points],differences were statistically significant (Z =-3.808,-3.965,P ＜ 0.01),and clinical remission score below clinically stable condition (Z =-3.808,P ＜0.01).A total of 19 cases of patients' pre-ELISA treatment index were positive correlation with after treatment stable period and clinical remission period (rs =0.788,0.752,P ＜ 0.01).Conclusions This study demonstrated that ELISA-detected BP180NCI6a-ELISA index was positively correlated with the BP disease severity and clinical course,which could be as the guideline to monitor and clinical treatment.