<p>Montelukast, a leukotriene receptor antagonist (LTRA), has demonstrated clear efficacy in relieving symptoms of allergic rhinitis (AR). However, its specific impact on the level of serum inflammatory factors and chemokines warrants further investigation. This article explored the influences of montelukast on the expression of inflammatory factors and chemokines in the serum of AR patients and investigated its potential immunomodulatory mechanisms.152 AR patients were randomly grouped: treatment group (TG) and control group (CG), with 76 cases in each group. Total nasal symptom scores (TNSS) and the expression of related factors were assessed at baseline, week 4, week 8, and during the 4-week follow-up period, with correlation analyses conducted. As against the CG, the TNSS scores in the TG visibly decreased at weeks 4 and 8 (<i>P &lt;</i> 0.01), with an efficacy rate of 82.9%. The levels of interleukin-4 (IL-4), IL-5, IL-13, tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and chemokines such as eotaxin, MCP-1, and RANTES were visibly reduced and remained at lower levels during the follow-up period (<i>P &lt;</i> 0.05). Pearson correlation analysis (PCA) showed that TNSS scores were positively correlated with the aforementioned inflammatory factors and chemokines, with the strongest correlations observed for MCP-1, IL-4, and eotaxin. Montelukast effectively alleviates clinical symptoms in AR patients, visibly downregulates the levels of multiple Th2-type inflammatory factors and chemokines in the serum, and demonstrates clear anti-inflammatory and immunomodulatory effects.</p>