Background: The aim of this study was to investigate the distribution of plasma asymmetrical dimethylarginine (ADMA) and homocysteine levels in Chinese patient with acute cerebral infarction (ACI) and their correlations with various risk factors. Methods: In total, 178 patients within the first 72 hours of ACI were assigned to 5 groups according to the Trial of Org 10172 in Acute Stroke Treatment classification and further divided into primary group and recurrent group; 52 healthy controls were also recruited in this study. Blood samples were collected for detecting plasma concentrations of ADMA and homocysteine and other biochemical parameters. Results: Plasma concentrations of ADMA and homocysteine were significantly higher in patients with ACI compared with healthy control (P < . 05) and varied among the different subsets of patients. Both the levels were significantly different between the primary group and recurrent group. Age, systolic pressure, blood glucose, total cholesterol, body mass index, ADMA, and homocysteine were significant risk factors for ACI in Chinese population. Correlation analysis showed that plasma ADMA level was positively correlated with the plasma level of homocysteine in patients with ACI, and each of them was positively correlated with age, systolic pressure, diastolic pressure, and total cholesterol, whereas homocysteine level was also found to be positively correlated with smoking. Conclusions: The current results indicated that ADMA and homocysteine were important contributors to the development of ACI among Chinese population, and plasma concentrations of ADMA and homocysteine were positively correlated with one another and other risk factors. Our study also suggested close-response relationships of plasma concentrations of ADMA and homocysteine to recurrent ACI.