Objective To investigate the correlation between serum silence information regulator homolog 1 (SIRT1), peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) and serum inflammatory factors and hearing prognosis in patients with sudden deafness. Methods A total of 88 patients with sudden deafness accepted by mudanjiang second people"s hospital from May 2020 to May 2022 were taken as the study group, the patients were grouped into good prognosis group and poor prognosis group according to their hearing recovery, in addition, 82 healthy people who had physical examination in mudanjiang second people"s hospital were collected as the control group. The levels of serum SIRT1, PGC-1α, inflammatory factor-tumor necrosis factor-α (TNF-α), interleukin-1β (L-1β) and hypersensitive C-reactive protein (hs-CRP) were measured by enzyme-linked immunosorbent assay. Pearson method was applied to analyze the correlation between the levels of serum SIRT1, PGC-1α and inflammatory factors. Logistic regression analysis was applied to analyze the influencing factors of hearing prognosis. Results The proportions of hypertension and diabetes in the study group were higher than those in the control group, and the levels of SIRT1 and PGC-1α were obviously lower than those in the control group, the levels of hs-CRP, IL-1β and TNF-α in the control group were obviously higher than those in the control group (P<0.05); the level of SIRT1 was negatively correlated with the levels of hs-CRP, IL-1β and TNF-α in patients with sudden deafness (r=-0.524, -0.384, -0.542, all P<0.05), the level of PGC-1α was negatively correlated with the levels of hs-CRP, IL-1β and TNF-α (r=-0.429, -0.457, -0.624, all P<0.05); the levels of hs-CRP, IL-1β and TNF-α in the poor prognosis group were obviously higher than those in the good prognosis group, the levels of SIRT1 and PGC-1α were obviously lower than those in the good prognosis group, and the proportions of patients with hypertension and diabetes were higher than those in the good prognosis group (P<0.05); Logistic regression analysis showed that SIRT1, PGC-1α, hs-CRP, IL-1β, TNF-α, history of hypertension, and history of diabetes were the influencing factors of hearing prognosis in patients with sudden deafness (P<0.05). Conclusion SIRT1 and PGC-1α are low expressed in the serum of patients with sudden deafness, and they are closely related to serum inflammatory factors, and are influential factors of hearing prognosis.