Aim To investigate the correlation between miR-25 expression in peripheral blood and apoptotic molecules contents, and 90 d prognosis of patients with acute cerebral infarction. Methods 162 patients with acute cerebral infarction were selected as the acute cerebral infarction group and 150 healthy people as the normal control group. Peripheral blood levels of miR-25 and apoptotic molecules cysteinyl aspartate specific proteinase-3(Caspase-3), B-cell lymphoma-2(bcl-2) were determined in acute cerebral infarction group and normal control group. According to the score of modified Rankin scale (mRS), prognosis of 90 d follow-up was divided into:good prognosis(mRS score≤2 points) and poor prognosis(mRS score ＞2 points). The clinical data of acute cerebral infarction patients with different prognosis were compared and further Logistic regression analysis was performed. ROC curve was used to evaluate the predictive value of miR-25 expression level in peripheral blood of acute cerebral infarction patients for adverse prognosis at 90 days. Results Expression levels of miR-25 and bcl-2 in peripheral blood of acute cerebral infarction group were lower than those in normal control group, levels of Caspase-3 were higher than those in normal control group(P＜0.05). Correlation analysis found that the expression level of miR-25 in peripheral blood of acute cerebral infarction patients was positively correlated with the expression level of bcl-2, negatively correlated with expression level of Caspase-3 (P＜0.05). Patients with acute cerebral infarction were followed up for 90 days, including 119 patients with good prognosis, 43 patients with poor prognosis. The differences in age, onset treatment time and NIHSS score on the day of admission in acute cerebral infarction patients with different prognosis were statistically significant(P＜0.05), while the differences in other clinical data were not statistically significant(P＞0.05). Logistic regression analysis found that:older age, higher NIHSS score on the day of admission, low expression level of miR-25 in peripheral blood were independent risk factors for poor prognosis in patients with acute cerebral infarction on 90 day(P＜0.05). ROC curve found that, cut-off value of miR-25 expression level in peripheral blood predicting the poor prognosis of patients with acute cerebral infarction on the 90 d was 0.635, AUC was 0.699(95%CI 0.609~0.789). The corresponding sensitivity and specificity were 72.09% and 65.55%, respectively.Conclusions Expression level of miR-25 in peripheral blood of patients with acute cerebral infarction decreases, which may be involved in the expression regulation of apoptotic molecules. Low level of miR-25 is a risk factor for poor prognosis and has certain early prediction value.