Objective To investigate the relationship between the expression levels of growth differentia-tion factor 15(GDF-15)and signal transduction molecule 3(SMAD3)in the serum of patients with acute cer-ebral hemorrhage and neurological dysfunction as well as prognosis.Methods A total of 109 patients with a-cute cerebral hemorrhage who were treated at the Gong'an County People's Hospital from June 2018 to June 2023 were selected as the research group.The National Institutes of Health Stroke Scale(NIHSS)score was used to assess the degree of neurological impairment in patients who were grouped into mild injury group(n=44),moderate injury group(n=37),and severe injury group(n=28).The modified Rankin scale was used to evaluate the prognosis of the patients,and they were divided into the good prognosis group(m=78)and the poor prognosis group(n=31).Another 80 healthy individuals who underwent physical examinations during the same period were selected as the control group.The serum GDF-15 and SMAD3 levels of each group were Detected and compared.The Spearman method was used to analyze the correlation between the levels of serum GDF-15 and SMAD3 and the degree of neurological function impairment.Logistic regression was used to ana-lyze the factors influencing the prognosis of patients.The receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of serum GDF-15 and SMAD3 levels for poor prognosis.Results Com-pared with the control group,the levels of serum GDF-15 and SMAD3 in the research group were significantly increased(P＜0.05).With the aggravation of the severity of neurological function impairment in patients with acute cerebral hemorrhage,the levels of serum GDF-15 and SMAD3 further increased(P＜0.05).The a-nalysis results of the Spearman method showed that the levels of serum GDF-15 and SMAD3 were positively correlated with the severity of neurological function impairment(P＜0.05).The levels of serum GDF-15 and SMAD3 in the poor prognosis group were significantly higher than those in the good prognosis group(P＜0.05).The cerebral hemorrhage volume,NIHSS score,proportion of hypertension and proportion of alcohol consumption history in the poor prognosis group were all higher than those in the good prognosis group(P＜0.05).Logistic regression analysis showed that elevated cerebral hemorrhage volume,NIHSS score,serum GDF-15 and SMAD3 levels were risk factors affecting the poor prognosis of patients(P＜0.05).The ROC curve analysis results indicated that the levels of serum GDF-15 and SMAD3 could predict the occurrence of poor prognosis in patients,and the combined detection of the two could improve the clinical predictive effica-cy.Conclusion The levels of serum GDF-15 and SMAD3 are closely related to neurological dysfunction and prognosis in patients with acute cerebral hemorrhage.The combination of the two has a high predictive value for the prognosis of patients with acute cerebral hemorrhage.