Aim To explore the correlation between plasma lipoprotein associated phospholipase A2 (Lp-PLA2), lipoprotein(a)[Lp(a)] and the progression of acute stage and vascular stenosis in patients with large atherosclerotic cerebral infarction. Methods 117 patients with large atherosclerotic cerebral infarction were collected, including 67 patients with non-progressive cerebral infarction (NPCI), and 50 patients with progressive cerebral infarction (PCI). According to head and neck CT angiography (CTA), magnetic resonance angiography (MRA) or digital subtraction angiography (DSA), the patients were divided into moderate stenosis group (48 cases), severe stenosis group (40 cases) and occlusion group (29 cases). The level of Lp-PLA2 and Lp(a) were measured and the differences among different groups were compared, and the correlation with the progression of cerebral infarction and the stenosis of the vessels was analyzed.Results There was no significant difference in gender, age, hypertension, coronary heart disease, smoking and drinking between PCI group and NPCI group (P＞0.05), and the levels of diabetes and low density lipoprotein cholesterol (LDLC) were higher than those in NPCI group (P＜0.05). The levels of Lp-PLA2 and Lp(a) in PCI group were significantly higher than those in NPCI group (P＜0.05 or P＜0.01). Compared with moderate stenosis group, the levels of Lp-PLA2 and Lp(a) in severe stenosis group and occlusion group were significantly increased (P＜0.05 or P＜0.01). And compared with the severe stenosis group, the levels of Lp-PLA2 and Lp(a) in occlusion group were significantly increased (P＜0.05). Spearman correlation analysis showed that Lp-PLA2 and Lp(a) levels were positively correlated with the degree of vascular stenosis in the head and neck (P＜0.05 or P＜0.01). Conclusion Lp-PLA2 and Lp(a) levels are closely related to the progression of cerebral infarction with large vascular atherosclerosis and the degree of vascular stenosis in the head and neck.