Background Behcet's disease (BD) is a chronic multisystem inflammatory disorder characterized by vasculitis. Vasculitis is thought to underlie many of the clinical manifestations of Behcet's disease. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a highly specific biomarker for vascular inflammation, and has low biological variability. Those features make it more attractive than other inflammatory markers including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), which may reflect systemic inflammation non-specifically. Objectives It was aimed to investigate circulating Lp-PLA2 levels and its relationship with CRP and ESR in patients with BD by considering disease activity. Methods Study group included 72 patients with BD (34 men and 38 women with a mean age of 35.3years) and 30 sex- and age-matched healthy subjects (15 men and 15 women with a mean age 32.6years). Patients group included 40 patients with active and 32 patients with inactive BD. Results Lp-PLA2, CRP and ESR levels were found to be significantly higher in patient group than controls. In addition, those levels were also significantly higher in patients with active BD than in patients with inactive disease. Lp-PLA2 showed positive correlations with CRP and ESR (r=0.63, P<0.05 and r=0.33, P<0.05 respectively). Lp-PLA2 also showed significant important area under curve (AUC) value (0.779), besides CRP (0.941) and ESR (0.888). Optimum cut-off value was obtained as 218.5ng/mL. Conclusions It was concluded that Lp-PLA2 may be a new useful biomarker to evaluate clinical or subclinical activity of the disease besides CRP and ESR.