Background and Aims Acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) always occurs in patients with traumatic enterorrhexis (TE) after surgery, which is life-threatening. So, selecting the appropriate indicators for early prediction and severity evaluation is of great importance This study was conducted to investigate the value of dynamic detection of surfactant protein-D (SP-D), surfactant protein-A (SP-A) and interleukin-1β (IL-1β) in peripheral blood for early prediction and severity evaluation of ALI/ARDS in TE patients after surgery.Methods The clinical data of 78 TE patients treated from August 2019 to December 2020 were retrospective analyzed. Of the patients, no postoperative lung injury occurred in 52 cases (control group), postoperative ALI occurred in 15 cases (ALI group) and ARDS occurred in 11 cases (ARDS group). The clinical data and the dynamic changes in serum levels of SP-D, SP-A and Il-1β in the three groups of patients were analyzed. The early prediction value and severity evaluation efficiency of each variable for occurrence of ALI/ARDS in TE patients after surgery were determined by receiver operating characteristic (ROC) curve and correlation analysis.Results There were no significant differences in age, sex, BMI, injury factors, injury site, operative time and intraoperative blood loss among the three groups (all P>0.05), while the mechanical ventilation time, procalcitonin (PTC) level, lung injury prediction score (LIPS) and lung injury score (LIS) were successively increased, and the oxygenation index was successively decreased in the order of control group, ALI group and ARDS group, and all differences had statistical significance (all P<0.05), The serum levels of SP-D, SP-A and IL-1β in ALI group before and at 1, 4, 7 d after surgery were successively and continuously increased in the order of control group, ALI group and ARDS group, and except no statistical significance was reached in SP-A level between ALI group and ARDS group at 7 d after surgery (P>0.05), all remaining differences had statistical significance (all P<0.05). ROC curve analysis showed that the area under curve of early prediction by either SP-D, SP-A or IL-1β for the occurrence of ALI/ARDS (0.800, 0.919 and 0.755/0.902, 0.931 and 0.957) was higher than the that of PCT (0.739/0.721) and LIPS score (0.851/0.788), the parallel combined test of the three parameters significantly increased the sensitivity of ALI/ARDS prediction to 0.997 and 0.988, and the series combined test of the three parameters significantly increased the specificity of ALI/ARDS prediction to 0.999 and 0.997. Correlation analysis revealed that SP-D, SP-A and IL-1β were negatively correlated with oxygenation index (r=-0.504, -0.657 and -0.717, all P<0.01) and positively correlated with LIS score (r=0.471, 0.654 and 0.634, all P<0.01).Conclusion All the levels of SP-D, SP-A and IL-1β in peripheral blood have certain value in early predicting the occurrence of ALI/ARDS and evaluating disease severity in TE patients after surgery. Their combined detection has a higher prediction and evaluation accuracy.