Objective To discuss the correlation between homocysteine （Hcy） and inflammatory responses as well as oxidative stress， and to analyze its role in the occurrence and development of acute ischemic stroke （AIS）. Methods Thirty-eight patients with their first incidence of AIS were selected as AIS group， and according to the principles of case-control study， 45 healthy individuals undergwent routine health examination during the same period were selected as control group. The levels of homocysteine and inflammatory cytokine interleukin （IL）-6， and tumor necrosis factor α （TNF-α） in serum of the subjects in two groups were detected by enzyme-linked immunosorbent assay （ELISA） method； the level of highly sensitive C-reactive protein （hs-CRP） of the subjects in two groups was detected by immunoturbidimetry； the levels of malondialdehyde （MDA） and activities of superoxide dismutase （SOD） in serum of the subjects in two groups were detected by chemical colorimetry； Pearson’s correlation analysis was used to analyze the correlation between serum Hcy level and levels of inflammatory markers and oxidative stress indicators of the AIS patients. Results Compared with control group， the levels of Hcy， hs-CRP， TNF-α， IL-6， and MDA in serum of the patients in AIS group were significantly increased （P<0.05）， while the activity of SOD was significantly decreased （P<0.05）. The level of Hcy in serum of the AIS patients was positively correlated with the levels of hs-CRP， TNF-α， IL-6， and MDA （r=0.615， P<0.05； r=0.632， P<0.05； r=0.598， P<0.05； r=0.612， P<0.05）， and negatively correlated with the activity of SOD （r=-0.325， P<0.05）. Conclusion The Hcy level in serum of the AIS patients is closely associated with the inflammatory factors and oxidative damage. Hcy can promote the production of oxidative free radicals and inflammatory factors and cause damage to the endothelial cells and play a significant clinical role in the occurrence and development of AIS.