Cerebral infarction is characterized by a high morbidity, disability, and fatality rate. This study explored the relationship between serum β2 microglobulin (β2-MG), HGF, lipoprotein-associated phospholipase A2 (Lp-PLA2) and carotid atherosclerosis in patients with hypertension combined with cerebral infarction and their prognostic value. A total of 320 patients with cerebral infarction complicated with hypertension who were hospitalized from January 2015 to January 2020 were collected. HGF, Lp-PLA2 and β2-MG levels were detected. Plaque score (Crouse score) was the patient's cumulative plaque thickness measurements. Additionally, the maximum plaque thickness and the number of plaques were measured.. The correlation was found between high β2-MG levels and the poor prognosis (HR: 1.29, 95% CI: 1.03-1.52, P = .022). Patients who had elevated levels of HGF were also less likely to have a positive outcome (HR: 1.38, 95% CI: 1.26-1.56, P = .015). High Lp-PLA2 levels were associated with a worse prognosis than low levels (HR: 1.74, 95% CI: 1.29-2.32, P = .015). In conclusion, the levels of β2-MG, HGF, and Lp-PLA2 in patients with hypertension combined with cerebral infarction were substantially linked with carotid plaques.