Objective To investigate the relationship of the serum levels and the genotypes of interleukin-1β(IL-1β) and IL-1 receptor antagonist with stroke. Methods The polymorphisms of IL-1β and IL-1Ra in 187 patients with stroke and 195 healthy controls were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), and the serum level of IL-1 was determined by enzyme-linked immunosorbent assay (ELISA). Results The serum level of interleukin-1 in stroke group was significantly higher than that in control group (P0.01). The IL-1β (+3 953 C/T) and IL-1Ra (VNTR) were significantly different between stroke group and control group. The serum IL-1Ra level of IL-1Ra Ⅱcarriers was significantly higher than that of non-carriers (P0.01). Conclusion The polymorphisms of IL-1β (+3 953 C/T) and IL-1Ra (VNTR) are associated with stroke, and T allele may be a risk factor for stroke. The IL-1Ra Ⅱcarriers may play a protective role by enhancing the IL-1Ra expression in the pathogenesis of stroke.