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Background Acute ischemic stroke (AIS) is characterized as a neurological deficit owing to an acute focal damage to the brain by cerebral infarction. A collateral score is the most significant factor evaluating the prognosis of AIS, its relationship with demographic data, serum biochemical parameters, and clinical disability in this field. Purpose Our research aims to examine the relationship between collateral score (CS) and biochemical parameters and clinical disability in patients with AIS with M1 occlusion in the middle cerebral artery (MCA). Materials and methods We conducted a single-center retrospective study with 100 patients with AIS who are in the first 6 hours of ischemic stroke. Data for consecutive AIS patients were collected from February 2019 to May 2020. The collateral score was assessed by using developed scoring systems defined by Maas et al. The correlations between collateral score and demographic data, biochemical parameters, NIHSS scores (National Institutes of Health Stroke Scale), mRS (modified Rankin scale) scores were recorded. Results The research was performed in 100 patients (median age, 71.55±11.46 years) and there was a statistically significant difference between elevated erythrocyte distribution width (RDW) and Maas collateral score (insular cortex) (p= 0.024) and lymphocyte/monocyte ratio (LMO) and Maas collateral (leptomeningeal) score (p = 0.025). Conclusion In patients with acute MCA M1 occlusion, our analysis found a significant association between elevated RDW, low LMO parameters and collateral score. We assume that in terms of simple and quick usability in acute stroke prognosis, these parameters are useful and functional as a new biomarker.