Abstract: Objective To explore the prognostic value of lipoxin A4 in patients with sepsis. Methods From June 2017 to March 2018, 40 patients with sepsis were admitted to the Department of Critical Care Medicine,Taizhou Hospital of Zhejiang Province.The general information, severity score, biochemical parameters, ICU stay, hospital stay and 28-day survival were collected. Plasma levels of lipoxin A4, TNF-α, IL-6, TGF-β1, ANG-1 and ANG-2 were detected by ELASA. The prognostic value of lipoxin A4 in patients with sepsis was analyzed by ROC and Kaplan-Meier. Results According to the expression level of lipoxin A4, sepsis patients were divided into L group (lipoxin A4 ≤ 55 ng/mL, n=21) and H group (lipoxin A4 > 55 ng/mL, n=19). APACHEⅡ, ANG-2 and ANG-2/ANG-1 in L group were significantly higher than those in the H group (all P<0.05). The TGF-β1, ANG-1 in H group were higher than the L group (all P<0.05). ROC curve showed that lipoxin A4 has a good predictive value for 28-day mortality in patients with sepsis (AUC:0.824; P=0.003). Kaplan-Meier survival method shown that the 28-day cumulative survival rate of patients in H group was significantly higher than that of the L group (log-rank test P=0.045). Conclusion The expression level of lipoxin A4 has a good predictive effect on the risk of death from sepsis.