〔Abstract〕 Objective To analyze the correlation of serum N-terminal B-type natriuretic peptide (NT–proBNP) and procalcitonin (PCT) with the severity of acute respiratory distress syndrome (ARDS) and the clinical value of dynamic monitoring. Methods 63 patients with ARDS who were treated in Zhengzhou First People's Hospital from March 2015 to March 2018 were selected and divided into severe group with 18 cases, moderate group with 26 cases and mild group with 19 cases according to their severity. The serum NT–proBNP and PCT levels of patients before treatment were detected. After 1 month observation, according to the survival of patients were divided into the survival group with 33 cases and death group with 30 cases. Then, the mild group admitted 24 hours, 48 hours and 72 hours serum NT-proBNP and PCT levels detection. According to the offline area of dynamic monitoring characteristic curve, the correlation between serum NT-proBNP and PCT and the degree of patients' illness and the clinical value of dynamic monitoring were evaluated and analyzed. Results The mortality rate was 47.6%. The levels of serum NT–proBNP and PCT in severe group were (4281.02 ± 6.89) pg·mL-1 and (1.88 ± 0.20) pg·mL-1, which were significantly higher than those in mild group (2009.5 ± 3.65) pg·mL-1 and (1.47 ± 0.17) pg·mL-1 and (3125.57 ± 5.15) pg·mL-1 and (1.68 ± 0.12) pg·mL-1 in the moderate group. The levels of serum NT–proBNP and PCT in moderate group were significantly higher than those in mild group (P < 0.05). The levels of NT–proBNP and PCT in serum of patients in death group were (3884.03 ± 7.85) pg·ml-1 and (1.85 ± 0.22) pg·ml-1, which were significantly higher than those in survival group (2897.04 ± 5.69) pg·ml-1 and (1.51 ± 0.21)(P < 0.05). The level of serum NT–proBNP, PCT and the offline area of dynamic monitoring curve were the largest in mild group 72 hours after admission, and the differences were statistically significant (P < 0.05). Conclusion The levels of serum NT-proBNP and PCT can predict the severity of ARDS patients. The levels of serum NT-proBNP and PCT at 72 hours after admission are of great significance to the prognosis of patients.