Abstract: OBJECTIVE To investigate the expression of Toll-like receptor 4（TLR4） in patients with central nervous system sepsis and its correlation with interleukin-6（IL-6） and procalcitonin（PCT） levels. METHODS From May 2018 to Jun. 2019, 78 patients with central nervous system sepsis in the Department of Critical Care Medicine, Shengli Oilfield Central Hospital were recruited as the experimental group. All patients were injected with Xuebijing on the basis of conventional treatment. Sixty-one volunteers who had physical examination during the same period were enrolled as the control group. enzyme-linked immunosorbent assay were used in both groups to determine the levels of IL-6; chemiluminescence was used to detect the level of PCT in the two groups; flow cytometry assay was used to detect the positive expression rate of TLR4 in the two groups. The Pearson correlation analysis was used to analyze the correlation between TLR4 expression and IL-6 and PCT levels in patients with central nervous system sepsis. RESULTS The levels of TLR4, IL-6 and PCT in the test group were significantly higher than that in the control group（P＜0.05）; the levels of TLR4, IL-6 and PCT in patients with purulent infection were significantly higher than that with viral infection and tuberculosis（P＜0.05）; TLR4, IL-6 and PCT levels in patients with viral infection were significantly higher than that in patients with tuberculosis infection（P＜0.05）. Nine patients died in the experimental group 6 months after the treatment, and the TLR4, IL-6 and PCT levels in the death group were significantly higher than that in the survival group（P＜0.05）. The positive rate of TLR4 expression in patients with central nervous system sepsis was positively correlated with IL-6 and PCT levels（r=0.794, 0.713, P＜0.001）. CONCLUSION TLR4 is highly expressed in patients with sepsis of the central nervous system and is correlated with IL-6 and PCT levels, which can guide patients’ treatment and improve their prognosis.