The role of matrix metalloproteinases (MMPs) and cytokines in the pathogenesis of Guillain-Barré syndrome (GBS) largely remains unknown. We studied the role of MMP-2, MMP-9, tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β) in disease progression and recovery of patients with GBS. Sixty-five patients with GBS and 68 healthy controls were enrolled in the study. Serum levels of MMP-2, MMP-9, TNF-α, and IL-1β were analyzed by ELISA, and activities of MMPs were measured by zymography. Expression of MMP-9, TNF-α, and IL-1β was higher in the progressive phase and lower in the recovery phase of GBS than in controls. A positive correlation of MMP-2 with IL-1β and MMP-9 with TNF-α and IL-1β was observed with progressive-phase GBS. The study shows that up-regulation of MMP-9 along with proinflammatory cytokines (TNF-α and IL-1β) in the early course appears to be associated with immune-mediated disease progression resulting from inflammation in the peripheral nervous system, whereas, during the later phase, down-regulation of MMP-9 and proinflammatory cytokines is implicated in recovery from the disease.