Abstract: Objective To explore early diagnosis and prognosis evaluation in acute cerebral infarction (onset < 24 h) using the heart acid binding protein (H-FABP) accompanied with neuron-specific enolase (NSE).Methods 109 patients with acute cerebral infarction (ACI group) were selected as experimental group. Then, the patients were divided into three subgroups(light, medium, heavy) according to the defect degree of nerve function. 80 patients with transient ischemic attack (TIA group) were selected as control group. H-FABP and NSE in serum, NIHSS score and volume of nidus were tested before and after treatment. The difference of H-FABP and NSE in serum before and after treatment were compared, and the relationships between H-FABP, NSE and NIHSS score and volume of nidus were explored.Results ①The serum H-FABP and NSE of ACI group were obviously higher than normal values(P<0.01). ②The H-FABP of ACI group was higher than that of TIA group (P<0.01). ③The serum H-FABP of the three subgroups from ACI group rose as the disease aggravated (P<0.01). ④The serum H-FABP of ACI group was positive related to NIHSS score and infarct volume(r_s=0.338,0.246,P<0.01). The serum NSE was positive related to infarct volume (r_s=0.203,P<0.05). The infarct volume was positive related to NIHSS score (r_s=0.265,P<0.01). ⑤The serum H-FABP and NSE of ACI group decreased after treatment as comparing with before treatment(P<0.05,P<0.01). The different values of serum H-FABP and NSE were positive related to different values of NIHSS score before and after treatment (r_s=0.665,0.512,P<0.01).Conclusion The serum H-FABP and NSE would rise abnormally in ACI patients and were positively related to nerve damage and the degree of prognosis. Both indexes can be used as sensitive indicators for disease outcome and prognosis evaluation.