Objective To analyze the relationship of serum small and dense low density lipoprotein cholesterol and homocysteine in cerebral infarction. Methods 135 patients with cerebral infarction admitted to our hospital from September 2018 to August 2019 were selected as the observation group, and 135 healthy volunteers who participated in physical examination in our hospital during the same period were selected as the control group. Results There were no significant differences in sex, average age, smoking, fib level between the observation group and the control group (P>0.05). The prevalence of hypertension, diabetes mellitus, TG, LDL-C, SDLDL-C, LP-PLA2, FBG, Hcy and D-D in the observation group were all higher than those in the control group (P<0.05). The TC, HDL-C, PT, APTT and TT levels in the observation group were all lower than those in the control group (P<0.05). According to NIHSS<4 points, 4~15 points and ≥16 points, the patients were divided into mild group (group A, n=53), moderate group (group B, n=49) and severe group (group C, n=33). Ldl-c, HDL-C, Hcy, SDLDL-C, LP-PLA2, D-D, PT, APTT, TT and FBG were compared in group A, group B and group C, and the differences were statistically significant (P<0.05). The difference of drinking rate between group A and group C was statistically significant (P<0.05). The difference of coronary heart disease prevalence and Fib level between group A and group C, group B and group C was statistically significant (P<0.05). Conclusion Small and dense low density lipoprotein cholesterol and homocysteine are associated with cerebral infarction.