The objective was to compare the expression of plasma stromal cell-derived factor 1 and the gene polymorphism in patients with pelvic inflammatory disease and healthy controls. The enzyme-linked immunosorbent assay and polymerase chain reaction-restriction fragment length polymorphism were, respectively, used to measure the plasma stromal cell-derived factor 1alpha level and stromal cell-derived factor 1 polymorphism in 50 healthy controls and in 44 patients with pelvic inflammatory disease before and after they received routine treatment protocols. The level of plasma stromal cell-derived factor 1alpha was elevated in patients with pelvic inflammatory disease compared to normal controls and decreased significantly after treatment. There were significant correlations between plasma stromal cell-derived factor 1alpha level and neutrophil count as well as between stromal cell-derived factor 1alpha level and white blood cell count in patients with pelvic inflammatory disease. There was no significantly different distribution of stromal cell-derived factor 1 genotypes between patients with pelvic inflammatory disease and normal controls. Patients with pelvic inflammatory disease having stromal cell-derived factor 1-3'A allele were associated with significantly elevated plasma stromal cell-derived factor 1alpha concentration compared to patients with pelvic inflammatory disease having G/G homozygous alleles (P < .02). In normal controls, there was no significant difference in the plasma stromal cell-derived factor 1 level between individuals with and without stromal cell-derived factor 1-3'A allele. When the cutoff level of plasma stromal cell-derived factor 1alpha level was determined to be 2192 pg/mL based on receiver-operating characteristic curve, the sensitivity, specificity, positive predictive value, and negative predictive value as well as accuracy were 77.3%, 88.0%, 85.0%, 81.5%, and 83.0%. In conclusion, when the cutoff level was determined to be 2192 pg/mL, plasma stromal cell-derived factor 1alpha level can be used to predict pelvic inflammatory disease.