Objective: We attempt to evaluate the role of neutrophil-to-lymphocyte ratio (NLR) in predicting 28-day mortality in patients with sepsis to investigate its prognostic value.Method: Relevant clinical and laboratory data of 91 healthy controls, 87 non-septic patients admitted to intensive care unit (ICU) and 127 septic patients on admission were collected, and septic patients were divided into survival (n=79) and death groups (n=48) according to their prognoses. NLR levels among different groups were compared and analyzed for associations with C-reactive protein (CRP), procalcitonin (PCT) and SOFA score. Univariate logistic regression analysis was used to assess the prognostic value of the NLR in patients with sepsis. Result: The NLR level was significantly higher in the septic patients compared to the case controls and healthy individuals (P < 0.05), and was much higher in septic patients who died (P < 0.05). ROC analysis indicated that the NLR had the best prognostic value for sepsis, with an AUC of 0.77 (95% CI: 0.69-0.84). Univariate logistic regression analysis suggested that NLR >8.25 was an independent risk factor for sepsis (odds ratio [OR] 6.39, P = 0.001). Correlation analysis suggested that the NLR was positively correlated with CRP, PCT and SOFA score.Conclusion: Peripheral serum NLR appeares to have a predictive value for 28-day mortality in patients with sepsis.