Objective To explore the relationships between the levels of NLRP3, interleukin1β (IL1β), interleukin18 (IL18) and prognosis in patients with hypertensive cerebral hemorrhage. Methods 80 patients with hypertensive intracerebral hemorrhage treated in our hospital from October 2016 to October 2018 were selected as the study group. According to the Glasgow prognosis scale (GOS) score, the patients were divided into good prognosis group (GOS score of 45, 46 patients) and poor prognosis group (GOS score of 13, 34 patients). 40 healthy people in the same period were selected as the control group. The expression of NLRP3 mRNA was detected by RTPCR, the levels of serum IL1β and IL18 were measured by enzymelinked immunosorbent assay (ELISA). Pearson was used to analyze the correlations between the expression of NLRP3 mRNA, the levels of serum IL1β, IL18 and the GOS score of patients' prognosis. The prognostic value of NLRP3 mRNA expression in patients with hypertensive cerebral hemorrhage was evaluated by ROC curve. Logistic regression analysis was used to analyze the factors influencing the poor prognosis of patients. Results The expression of NLRP3 mRNA and the levels of IL1β and IL18 in the poor prognosis group were significantly higher than those in the good prognosis group (P＜005). The expression of NLRP3 mRNA in peripheral blood and the levels of IL1β and IL18 in serum were moderately negatively correlated with the prognosis GOS of patients with hypertensive cerebral hemorrhage (P＜005). AUC of ROC curve in predicting the prognosis of hypertensive intracerebral hemorrhage was 0853 (95% CI: 07730933), cutoff value was 1469, and corresponding sensitivity and specificity were 882% and 652%, respectively. The results of multivariate logistic regression showed that bleeding volume (OR=2136, 95% CI: 14263201, P＜005), NIHSS score (OR=2143, 95% CI: 15972876, P＜005), NLRP3 mRNA expression level (OR=2004, 95% CI: 11243573, P＜005) were independent risk factors for poor prognosis in patients with hypertensive cerebral hemorrhage. Conclusion The expression of NLRP3 mRNA in peripheral blood of patients with poor prognosis of hypertensive cerebral hemorrhage is increased, the levels of IL1β and IL18 are also increased, and all of them are negatively correlated with GOS. The expression of NLRP3 mRNA can be used as an index to predict the prognosis of patients with hypertensive cerebral hemorrhage. 