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BackgroundHepatocellular carcinoma (HCC) accounts for 85%–90% of primary liver cancers and is the seventh most common cancer worldwide. The purpose of this study is to determine an innovative and effective clinical index for prognosis prediction in HCC patients. MethodsA total of 132 patients with HCC were included in this research. A cohort of 72 cases was obtained through propensity score-matching. Patients were divided into high- and low-level groups based on the ratio of preoperative uric acid levels to lymphocytes. The differences in clinical characteristics and survival indicators were compared between the two groups.ResultsThere was a statistical difference between uric acid-to-lymphocyte ratio (ULR) level and tumor size (P < 0.01). Multivariate analysis showed that ULR (P = 0.03) and tumor size (P = 0.03) were independent risk factors for overall survival (OS). ULR (P < 0.04) and diabetes (P = 0.04) were independent risk factors for progression-free survival (PFS) in HCC patients. Further survival analysis of the entire cohort and propensity score-matching cohort showed that the OS and PFS in the high-level ULR group were significantly shorter than those in the low-level ULR group (log-rank P < 0.001). Conclusion This study demonstrated that ULR is a marker of poor prognosis in postoperative HCC patients, while high ULR levels predicted shorter OS and PFS.