Aim:This study was to evaluate the prognostic value of serum endothelin-1 (ET-1), monocyte chemotactic protein-1 (MCP-1), and lactic acid (LA) levels in patients with ruptured intracranial aneurysm (IA) after interventional embolizationMaterial and Methods:Patients with ruptured IA were divided into mild, moderate, and severe groups according to Hunt-Hess grades, and the correlation between serum parameters and disease severity was analyzed. Multivariate logistic regression was employed to analyze the influence of serum ET-1, MCP-1, and LA levels on the prognosis of patients, and ROC curves were plotted to analyze the predictive value of these parameters.Results:There were 29 cases in the mild group (grade Ⅰ), 49 cases in the moderate group (grade Ⅱ-Ⅲ), and 25 cases in the severe group (grade Ⅳ-Ⅴ). In the severe group, serum ET-1, MCP-1, and LA were elevated compared to the moderate and mild groups, with the moderate group showing higher levels than the mild group. Serum ET-1, MCP-1, and LA levels were positively correlated with the severity of IA (P < 0.05). The Hunt-Hess grade, Fisher grade, and serum ET-1, MCP-1, and LA levels in patients with poor prognosis were higher than those with good prognosis. Hunt-Hess grade Ⅳ-Ⅴ, Fisher grade 3 to 4, ET-1 ≥ 41.78 pg/mL, MCP-1 ≥ 229.05 ng/L, and LA ≥ 7.13 mmol/L were risk factors affecting the prognosis of patients after interventional embolization. The AUC values of serum ET-1, MCP-1, and LA levels to evaluate the prognosis of patients were 0.772, 0.871, and 0.791, respectivelyConclusion:Serum ET-1, MCP-1, and LA levels correlate with disease severity in patients with ruptured IA and have predictive values for the prognosis of patients after interventional embolization. They are risk factors for poor prognosis of patients after interventional embolization.