Background The prognostic value of serum C-reactive protein (CRP) in patients with infective endocarditis (IE) is not well elucidated.This study aimed to evaluate the usefulness of CRP in predicting the outcome of IE.Methods Two hundred ninty-six patients from 2009 to 2012 in the Department of Cardiology at Guangdong General Hospital were screened and divided into surgical and conventional treatment groups.CRP,white blood cell (WBC),erythrocyte sedimentation rate (ESR) and other clinical data were obtained with follow-up for 12 months.Results Two hundred thirty-six patients were assigned to receive surgery treatment while 60 patients received conventional treatment.In the surgery group,the level of CRP in the death patients was significantly higher than that in the survival patients (P＜0.001).The area under the curve of ROC was about 0.749 (SE0.064,P=-0.005,95％CI,0.624-0.874) and the cut-off point of CRP was 23.8mg/L.In conventional group,there was significant difference between death and survival (P ＜0.001).The area under the curve of ROC was about 0.701 (SE0.095,P=0.032,95％CI,0.515-0.888) and the cut-off points of CRP was 65.6 mg/L.There were no significant differences in WBC and ESR between surgery and conventional groups.Conclusion A more aggressive surgical intervention results in a better outcome over conventional treatment and CRP could be served as a predictive marker for adverse outcome in IE patients.