Abstract： Objective To investigate the application of combined detection of serum lipoprotein(a) and total bile acid in patients with acute cerebral infarction to make accurate judgments of the state of an illness and to make differential diagnosis of acute cerebral infarction and other cerebral vascular disease based the obtained data. Methods Fasting hemospasia samples were harvested by the common tube in the morning from three groups in patients with acute cerebral infarction who visiting hospital and hospitalize in our hospital, patients with acute cerebral hemorrhage who visiting hospital and hospitalize in our hospital and healthy physical examinees to determine the levels of serum lipoprotein (a)and total bile acid by Roche Hitachi automatic biochemistry analyzer PPI and imported reagent of Randox company. The obtained data was analyzed by means of SPSS software. The data were expressed as (-x) ± s, and measured by t test. Results Compared with patients with acute cerebral hemorrhage control group and healthy physical examinees control group, the serum lipoprotein (a) and total bile acid levels in acute cerebral infarction group increased significantly. There were significant difference between them (P＜ 0. 01 or P＜ 0. 05). The serum lipoprotein (a)and total bile acid levels were different among various infarct size groups, large infarct size group ＞ small infarct size group ＞ lacunar infarction group. There were significant difference among three groups (P＜ 0. 05 or P＜ 0. 01). Conclusion Combined detection of lipoprotein(a)and total bile acid can provide more accurate and quick diagnosis and can increase diagnosis positive rate. It shows that the serum lipoprotein(a) and total bile acid play an important role in the development of acute cerebral infarction, and the serum lipoprotein(a) and total bile acid exhibit a positive correlation with severity of disease and infarct size.