Objective To investigate the correlationship of serum phospholipase A2 receptor (PLA2R) antibody in diagnosis and disease evaluation of patients with membranous nephropathy. Methods 193 patients with membranous nephropathy from May 2013 to February 2015 were divided into three groups according to the results of renal biopsy, IMN group, secondary membranous nephropathy (SMN group), 30 healthy subjects as control group. Copare the indexes as followed: serum albumin, total serum protein, 24 h urinary protein, serum creatinine, PLA2R antibody concentration and its' positive rate. Correlation analysis laboratory indexes and PLA2R antibodies and calculate specificity and positive predictive value PLA2R antibody detection. Results The levels of serum albumin and serum total protein in IMN group and SMN group were significantly lower than those in control group (P < 0.05), 24 h urine protein, serum creatinine were significantly higher than those in control group (P < 0.05). The difference between the IMN group and the SMN group was not statistically significant (P > 0.05). The positive rates of serum PLA2R antibody levels in IMN group, SMN group and control group were (5.207 ± 12.149) g/ml, (3.218 ± 8.492) g/ml, (0.001 ± 0.003) g/ml, the positive rate was 68.99 %, 18.75 %, 0.00 % respectively, the difference was statistically significant (P < 0.05). Serum albumin level was significantly negatively correlated with serum PLA2R antibody in patients with MN (r = -0.625, P = 0.023), and serum PLA2R antibody was positively correlated with 24 h (r = 0.796, P = 0.015). The specificity of PLA2R antibody detection was 96.67 %, the positive predictive value was 99.01 %, and the positive predictive value was 99.01 %. Conclusions PLA2R serum antibody levels with membranous nephropathy disease has obvious relevance, its expression and renal biopsy results consistent with a higher degree.