Abstract: OBJECTIVE To investigate the distribution of pathogens causing infections in elderly patients with acute cerebral infarction and observe the influence on levels of endothelin and brain natriuretic peptide (BNP) so as to provide guidance for clinical treatment. METHODS A total of 82 elderly patients with acute cerebral infarction complicated with infections who were treated in the hospital from Mar 2010 to Aug 2014 were assigned as the infection group, meanwhile, 100 elderly acute cerebral infarction patients without infections were set as the non-infection group, and 100 healthy people who underwent the physical examination were chosen as the control group. The distribution of pathogens and clinical indicators were observed and compared among the three groups of participants, and the statistical analysis of data was performed with the use of SPSS 19.0 software. RESULTS Totally 80 strains of pathogens were isolated from 80 patients in the infection group, of which 57.5% (46 strains) were gram-negative bacteria. The levels of serum endothelin, tumor necrosis factorα (TNFα), transforming growth factor β (TGFβ), fibroblast growth factor (bFGF), interleukin-6 (IL-6), and interleukin-10(IL-10) were significantly higher in the infection group than in other two groups (P<0.01). CONCLUSION The elderly patients with acute cerebral infarction tend to be infected with pathogens, the gram-negative bacteria are dominant among the pathogens, and the infections may lead to the elevated level of serum endothelin and the remarkable reduction of level of BNP.