Objective: This study aimed to explore the correlation of Homocysteine (Hcy) and inflammation level with cerebral infarction (CI) in hypertensive patients. Methods: A total of 122 hypertensive patients were selected from our hospital as the objects of the study and divided into stroke group (SG, n=51) and non-stroke group (NSG, n=71) according to whether they were diagnosed with CI. Besides, 50 healthy individuals were selected and included in control group (CG). Hcy, total cholesterol (TC), triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C), tumor necrosis factor-alpha (TNF-alpha), C-reaction protein (CRP) and interleukin-6 (IL-6) were detected and compared among the three groups. Active treatment and follow-up visit were provided for SG to compare the changes of Hcy, TNF-alpha and scores for National Institutes of Health Stroke Scale (NIHSS) before treatment and at 1, 3 and 6 months after treatment. The last part was an analysis on correlation of Hcy, TNF-alpha, IL-6 and CRP with hypertensive cerebral infarction (HCI). Results: The levels of Hcy, TC, TG, LDL-C, TNF-alpha, IL-6 and CRP in SG were higher than those in NSG and CG, and those of NSG were higher than those of CG, showing statistically significant difference between groups (P<0.05). Hcy, TNF-alpha and NHISS scores of SG were reduced significantly after treatment, indicating significant difference compared with those before treatment (P<0.05). Conclusion: The levels of Hcy and inflammatory factors were positively correlated with CI incidence in hypertensive patients. The hypertensive patients with abnormally higher laboratory indices mentioned above should be treated actively to prevent CI and thus improve prognosis.