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Introduction: The aim was to determine whether secretory phospholipase-A2 (sPLA2) activity and fatty acids in cerebrospinal fluid (CSF) are correlated with liver enzymes tests. Methods: CSF and serum samples were collected from 49 patients (age 18-65) as part of routine diagnostic testing. Along with serum liver enzymes aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP), the fatty acid composition of CSF was measured by gas liquid chromatography. CSF enzyme activities of sPLA2 were measured using the standard assay with diheptanoyl thio-phosphatidylcholin as substrate. Results: The saturated fatty acids (SFAs) including palmitic acid and stearic acid were positively, and the unsaturated fatty acids including oleic acid and linoleic acid were negatively correlated with liver enzymes tests. In regression analysis with adjustment for body mass index (BMI), the elevated liver enzymes tests were positively associated with activity of sPLA2 (β > 0.31, P < 0.050) and total SFAs (β > 0.38, P < 0.010) and negatively with total monounsaturated fatty acids (MUFAs) (β < -0.40, P < 0.001) contents of CSF. Conclusion: CSF activity of sPLA2 and fatty acids may be linked to peripheral markers of liver function, suggesting an indirect impact of central fatty acids on hepatocytes function and metabolism.