Objective：To explore the effects of temozolomide combined with postoperative treatment on serum miR-181b and miR-497 levels in patients with glioma. Methods：Seventy-six patients with postoperative glioma were randomly divided into two groups，namely，group A（n=38）and group B（n=38）. Patients in group A were treated with semustine and those in group B were treated with semustine combined with temozolomide. After the treatment，the effective rate，1-year，2-year and 3-year survival rates，Karnofsky scores in the two groups were compared. The serum samples of patients in B group were collected to detect the changes of miR-181b and miR-497 expression before and after treatment. Results：Objective response rate and disease control rate in group B were significantly higher than those in group A（P < 0.05）. The median survival time in group A was shorter than that in group B. And 1-year，2-year and 3-year survival rates after the operation in group A were significantly lower than those in group B（P < 0.05）. Karnofsky scores after the treatment was significantly lower in group A than that in group B（P < 0.05）. The serum levels of miR-181b were significantly increased after operation［postoperative（162.34 ± 51.79）fmol/L vs. preoperative（91.37 ± 40.41）fmol/L，P < 0.05］. The serum levels of miR-497 were significantly increased after operation［postoperative（166.23 ± 53.68）fmol/L vs. preoperative（88.36 ± 36.72）fmol/L，P < 0.05］. Conclusion：Temozolomide combined with postoperative treatment can improve the expression of miR-181b and miR-497 in serum of patients with glioma，and miR-181b and miR-497 can be used for the diagnosis and prognosis of glioma.