Objective To explore the relationships between peripheral blood inflammatory markers and acute ischemic stroke (AIS). Methods A total of 80 AIS patients in Neurovascular Center of The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Aug. to Dec. 2022 were enrolled. According to the National Institutes of Health stroke scale (NIHSS) score, the patients were categorized into mild AIS group (NIHSS＜4, n=50) or moderate-to-severe AIS group (NIHSS≥4, n=30). According to the 90-day modified Rankin scale (mRS) score, the patients were categorized into favorable outcome group (mRS 0-2, n=74) or unfavorable outcome group (mRS 3-6, n=6). The basic clinical data, peripheral blood inflammatory markers (including monocyte to lymphocyte ratio ［MLR］, neutrophil to lymphocyte ratio ［NLR］, platelet to lymphocyte ratio ［PLR］, systemic immune-inflammation index ［SII］, and systemic inflammatory response index ［SIRI］), and other laboratory data of the patients in each group were collected and compared. Results Compared with the mild AIS group, the moderate-to-severe AIS group had a significantly higher proportion of hyperlipidemia history (43.3% ［13/30］vs 18.0% ［9/50］, P=0.014) and significantly higher NLR (2.81 ［1.93, 5.97］ vs 2.01 ［1.64, 3.37］, P=0.028). Compared with the favorable outcome group, the unfavorable outcome group had a significantly higher proportion of hyperlipidemia history (83.3% ［5/6］ vs 23.0% ［17/74］, P=0.007), but there were no differences in MLR, NLR, PLR, SII, or SIRI (all P＞0.05). Conclusion Moderate-to-severe AIS patients have higher NLR.