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Altered expression of serum microRNAs (miRNA) has been reported to correlate with carcinogenesis and progression of glioblastoma (GBM). This study assessed the potential diagnostic and prognostic value of serum miR-29b for GBM. Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was used to detect the expression levels of serum miR-29b in 107 patients with GBM patients, 40 patients with anaplastic astrocytoma (AA) and 80 healthy volunteers. The results showed that serum miR-29b levels were much lower in patients with GBM than in those with AA or healthy controls. Receiver operating characteristic (ROC) curve analysis revealed that serum exosomal miR-29b could effectively distinguish GBM patients from AA patients or normal controls. In addition, serum exosomal miR-29b level was significantly increased after treatment. Low serum exosomal miR-29b expression was strongly associated with aggressive clinical findings and shorter survival. Moreover, the Cox regression analysis demonstrated that serum exosomal miR-29b was an independent prognostic indicator. Collectively, serum exosomal miR-29b might be a promising biomarker for predicting prognosis of GBM., Competing Interests: None., (IJCEP Copyright © 2019.)