Abstract: OBJECTIVE To analyze the relationship between tumor necrosis factor-α（TNF-α） and tumor necrosis factor receptor Ⅱ（TNFRⅡ） gene polymorphisms and pulmonary infection after cerebral infarction. METHODS Patients with pulmonary infection after cerebral infarction and those without pulmonary infection who were diagnosed and treated in the department of neurology at the Second People’s Hospital of Lianyungang City between Jan 2017 and Jun 2020 were enrolled in this study and divided into the pulmonary infection group and cerebral infarction group; 40 healthy volunteers during the same period were recruited as the control group. The general data of the three groups were compared. TNF-α（G308 A） and TNFRⅡ（T196 G） polymorphisms were determined by polymerase chain reaction-restriction fragment length polymorphism（PCR-RFLP） method and compared among the three groups. Logistic regression analysis of the relationship between TNF-α（G308 A） and TNFRⅡ（T196 G） polymorphisms and pulmonary infection after cerebral infarction was performed; the clinical pulmonary infection scores（CPIS） in patients with pulmonary infection after cerebral infarction and different types gene polymorphisms were compared. RESULTS Allele frequencies of TNF-α（G308 A） and TNFRⅡ（T196 G） were in accordance with the Hardy-Weinberg law. There were significant differences in TNF-α（G308 A） genotype frequency and allele frequency among the three groups（P＜0.05）, while there were no statistically differences in TNFRⅡ（T196 G） genotype frequency and allele frequency among the them. Multivariate Logistic regression analysis showed that complete bed rest, invasive operation, NIHSS score ＞14 at admission, TNF-α（G308 A） genotype-AA type, and TNF-α（G308 A） allele-A were risk factors for pulmonary infection after cerebral infarction（P＜0.05）. Patients carrying TNF-α（G308 A） AA genotype and A allele had significantly higher CPIS scores than those carrying GG, AG genotypes and G allele（P＜0.05）. CONCLUSION Pulmonary infection and its severity after cerebral infarction are related to TNF-α（G308 A） polymorphisms, but there is no significant correlation with TNFRⅡ（T196 G） polymorphisms.