Abstract: OBJECTIVE To study the monitoring value of serum PCT, CRP, ESR levels and WBC count in patients in early fever after joint replacement surgery, so as to be able to provide detection, prevention and treatment timely for patients. METHODS A total of 160 cases of patients with fever after joint replacement surgery from Jan. 2013 to Dec. 2014 were selected. According to the results of cultivation of bacteriology, patients were divided into infection group (n=72) and the uninfected group (n=88). The level of serum PCT, CRP, ESR and WBC count were compared between the two groups of patients. RESULTS Before the operation, the PCT, CRP, ESR, WBC indexes in two groups were similar, but after the operation, the indexes of PCT, CRP and ESR in infection group were obviously higher than in uninfected group and the WBC count was similar. The trend of indexes of PCT, CRP, ESR and WBC in uninfected group first rose up then fell down. After 7 days of operation, the WBC and PCT recovered to preoperative levels, but ESR and CRP levels were still high. In patients with postoperative fever, the change of PCT level in patients with different types of infection had significant difference (P<0.05), which could be used for the identification of different types infections, but CRP, ESR and WBC had no significant difference in different types of infections. The curves of PCT, CRP and ESR on ROC were all statistically significant (P<0.05), which could be used in the diagnosis of postoperative fever caused by infection. CONCLUSION Reasonable choice of infection indexes in the early diagnosis of infection of patients with joint replacement has good reference value. PCT has less influence by the surgery, which can be used to identify the types of infection, and ESR and CRP can be used as auxiliary indexes.