Abstract： Aim To explore the predictive significance of monocyte/high-density lipoprotein cholesterol ratio(MHR)for early neurological deterioration(END)in acute pontine infarction.Methods 803 patients with acute pontine infarction were ret-rospectively selected and divided into END group and non-END group based on whether END occurred.Clinical data,MHR,infarct size(IS),infarct type,and admission NIHSS score were compared between two groups.The correlation between MHR and IS,as well as the type of infarction,were analyzed.Multivariate Logistic analysis was used to investigate the influencing factors of END in patients with acute pontine infarction.The predictive value of ROC on risk factors for the occurrence of END was also analyzed.Results Age,time from onset to admission,length of hospital stay,NIHSS score upon admission,and hypertension ratio in two groups of patients have significant difference(P＜0.05).The MHR and IS of the END group were higher than those of the non-END group(P＜0.05),and there were more paramedian pontine infarction(PPI)patients in the END group than in the non-END group(P＜0.05).The MHR in the END group was positively correlated with IS(P＜0.001).The admission NIHSS score,MHR,advanced age,hypertension,IS,and PPI are risk factors for the occurrence of END in patients with pontine infarction(P＜0.05).The combi-nation of MHR and other indicators has good predictive value for the occurrence of END in pontine infarction.Conclusion MHR has good predictive value for acute pontine infarction(END),and can provide reference for clinical practice.