Objective To investigate the correlation of heme oxygenase-1 (HO-1) and soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) levels with neurological function and cognitive function in patients with acute ischemic stroke (AIS). Methods The case group included 105 patients with AIS in the hospital from August 2020 to October 2023, and the control group was consisted of 85 healthy volunteers who received physical examination during the same period. The general data and serum levels of HO-1 and sLOX-1 were compared between both groups. Pearson analysis was used to analyze the correlation between serum HO-1 and sLOX-1 levels and neurological function and cognitive function. Results The levels of serum HO-1 and sLOX-1, score of National Institutes of Health Stroke Scale (NIHSS) and score of Neurological Functional Deficit Scale (NFDS) in the case group were higher than those in the control group (P<0.05) while the score of Montreal Cognitive Assessment Scale (MoCA) and score of Mini-Mental State Examination (MMSE) were lower than those in the control group (P<0.05). In the case group, there were 88 cases of mild neurological deficit and 17 cases of moderate neurological deficit. Compared with the control group, the levels of HO-1 and sLOX-1 in the mild and moderate defect groups were higher (P<0.05), and the above levels in the moderate defect group were higher than those in the mild defect group (P<0.05). 15 patients had normal cognitive function and 90 patients had cognitive impairment in the case group. Compared with the control group, the levels of HO-1 and sLOX-1 in normal cognitive group, simple cognitive impairment group, mild nerve deficit group, moderate nerve deficit group and nerve function deficit with cognitive impairment group were higher (P<0.05). The levels of HO-1 and sLOX-1 in patients with neurological impairment combined with cognitive impairment were higher than those in simple cognitive impairment group, mild nerve impairment group and moderate nerve impairment group (P<0.05). Serum HO-1 and sLOX-1 levels in patients with AIS were positively correlated with NIHSS and NFDS (P<0.05), but were negatively correlated with MoCA and MMSE (P<0.05). Conclusion The levels of serum HO-1 and sLOX-1 and scores of neurological deficits in patients with acute ischemic stroke are highly expressed while the cognitive function scores are lowly expressed. There is a close correlation between levels of serum HO-1 and sLOX-1 and neurological function and cognitive function