Abstract: Objective：To detect the levels of serum miR-106b-5p in acute ischemic stroke(IS) patients and evaluate its potential as a molecular biomarker for the diagnosis of IS. Methods：Serum miRNA profiles in four acute IS patients and ten healthy volunteers were screened by miRNA microarray analysis. Then, the levels of serum miR-106b-5p in 53 acute IS patients and 50 healthy controls were detected with quantitative real-time polymerase chain reaction. Next, the receiver operating characteristic(ROC) curves were drawn to analyze the sensitivity and specificity of miR-106b-5p in the diagnosis of acute IS. Results：The expression levels of serum miR-106b-5p in IS patients were significantly higher than that in healthy controls(［67.13±4.13］ fmol/L vs ［40.48±2.62］ fmol/L, t=5.41, P<0.01). The area under the ROC curve of miR-106b-5p for the diagnosis of acute IS was 0.78(95%CI: 0.69 0.87). When the cutoff value was 40 fmol/L, the sensitivity and specificity of miR-106b-5p for the diagnosis of acute IS were 79.25% and 64.71%, respectively. Conclusion：The levels of serum miR-106b-5p in acute IS patients increased obviously, which may improve the accuracy of the diagnosis of IS when combined with clinical symptoms of IS patients.