Objective: This study aimed to compare serum levels of CD163, YKL-40, and VILIP-1 between children with autism spectrum disorder (ASD) and healthy controls, while also investigating their association with the severity of ASD and language development. Methods: The study included 40 ASD-diagnosed patients (aged 18−72 months) and 40 age-matched healthy controls.Childhood Autism Rating Scale, Preschool Language Scale-4, and Ankara Development Screening Inventory were administered to children in the ASD group. Serum CD163, YKL-40 and VILIP-1 levels were measured with an enzyme-linked immunosorbent assay kit. Results: In the ASD group compared to the control group, serum VILIP-1 levels were significantly higher (p = 0.046).No significant differences were observed in mean serum CD163 and YKL-40 levels between patients and controls (p = 0.613, p = 0.769). Interestingly, a positive correlation was observed between CD163 and YKL-40 levels and ASD severity (p ＜ 0.001 for both). Additionally, CD163 and YKL-40 levels showed significant predictive value for ASD severity.While no significant associations were found between CD163 and YKL-40 levels and language development, a negative correlation was observed between VILIP-1 levels and language development (p ＜ 0.001). Conclusion Our findings highlight that the levels of CD163 and YKL-40 significantly predicted ASD severity, indicating a potential role of neuroinflammation in the development of ASD.