Aim To investigate relationship between the expression of microRNA （miRNA） and inflammatory cytokines in plasma in patients with acute cerebral infarction （ACI） and its clinical significance. Methods Sixty patients with ACI were divided into three groups according to clinical neurological deficit score. The patients were further divided into non-survival group and survival group based on their outcomes. 20 Healthy volunteers were enrolled into the control group. The expression levels of plasma miR-210,miR-145,miR-21,miR-223,miR-497,miR-15a were detected by real-time quantitative PCR（qRT-PCR）. Tumor necrosis factor-α （TNF-α） and interleukin-10 （IL-10） levels in plasma were detected by enzyme linked immunosorbent assay （ELISA）. Results Expression of miRNA and level of TNF-α,TNF-α/IL-10,IL-10 were significantly increased in patients with ACI compared with normal control group Expression of miRNA and level of TNF-α,TNF-α/IL-10,IL-10 were gradually increased. Among the patients,the level of TNF-α,TNF-α/IL-10,IL-10 in the survival group were obviously lower than those in the non-survival group （P<0.05 or P<0.01）. There was a positive correlation between miR-21,miR-223 and IL-10 and IL-10/TNF-α（ P<0.01）. Conclusion The expression levels of miR-21 and miR-223 in plasma in patients with ACI was significantly upregulated,and had a positive correlation with IL-10 and IL-10/TNF-α,which may be used as early diagnostic markers and can reflect the severity of condition to a certain degree.