Objective To investigate the correlation between the changes of TNF-α, Tim-1, TLR4 and the severity of allergic rhinitis (AR). Methods A total of 77 AR patients received in our hospital from 2021.10 to 2022.10 were selected as the study group, and 100 healthy subjects were selected as the control group during the same period. Serum TNF-α, Tim-1 and TLR4 levels were detected. Pearson correlation analysis was used to analyze the relationship between serum TNF-α, Tim-1, TLR4 levels and the severity of the disease. Multivariate Logistic regression was used to analyze the risk factors affecting AR. Results Serum levels of TNF-α, Tim-1, TLR4 and SFAR scores in severe patients were higher than those in mild and moderate patients in control group and study group (P <0.05). Serum levels of TNF-α, Tim-1 and TLR4 were positively correlated with SFAR scores (P < 0.05). TNF-α, Tim-1 and TLR4 were the risk factors affecting the severity of AR disease (P < 0.05). Conclusion The serum levels of TNF-α, Tim-1 and TLR4 in AR patients increased with the development of the severity of the disease, and the changes of serum TNF-α, Tim-1 and TLR4 were positively correlated with SFAR scores. Meanwhile, the levels of TNF-α, Tim-1 and TLR4 were the influencing factors for the severity of AR. The degree of AR disease can be evaluated by monitoring the change of its level in clinic