Objective To study the relationship of serum liver enzymes indexes, interleukin-6 (IL-6) and procalcitonin (PCT) levels with occurrence of acute kidney injury (AKI) in patients with bee stings. Methods The clinical data of 98 patients with bee stings admitted to our hospital from June 2022 to May 2024 were retrospectively analyzed, and the incidence of AKI was statistically analyzed. They were divided into AKI group and non-AKI group. The clinical data of the two groups were compared, including serum liver enzymes indexes such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), IL-6 and PCT. Multivariate Logistic regression analysis was performed to explore the influencing factors of AKI in patients with bee stings. ROC curve was drawn to analyze the predictive efficiency of serum liver enzymes indexes, IL-6 and PCT on the occurrence of AKI. Results There were 18 cases of AKI among the 98 patients, with the incidence of AKI of 18.37%. The number of bee stings, white blood cell count (WBC), international normalized ratio (INR), total bilirubin (TBil), ALT, AST, IL-6, PCT, creatine kinase (CK), myoglobin (MYO) and lactic acid (Lac) in the AKI group were higher than those in the non-AKI group (P<0.05), the time from bee sting to treatment and activated partial thromboplastin time (APTT) were longer compared with those in the non-AKI group (P<0.05). Multivariate analysis indicated that the number of bee stings, ALT, AST, IL-6 and PCT were the influencing factors of AKI in patients with bee stings (P<0.05). The AUCs of serum ALT, AST, IL-6 and PCT and combined detection in predicting the occurrence of AKI were 0.737, 0.748, 0.754 and 0.725, the sensitivities were 77.27%, 72.73%, 77.27%, 81.82% and 90.91%, and the specificities were 68.42%, 71.05%, 69.74%, 59.21% and 78.95% respectively. The predictive efficiency of combined detection of serum liver enzymes indexes, IL-6 and PCT for the occurrence of AKI in patients with bee stings was higher than that of single detection of each index (P<0.05). Conclusion The levels of serum ALT, AST, IL-6 and PCT in patients with bee stings complicated with AKI are significantly higher, and they are related to the occurrence of AKI. The combined detection of serum ALT, AST, IL-6 and PCT levels is helpful to predict the occurrence of AKI in patients with bee stings