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Background: Neutrophil to lymphocyte ratio (NLR) is a marker for an immunological response, associated with worse outcomes in many types of cancer. Publications show an association of NLR with poor survival in gastric cancer patients; however, no consensus exists on whether it can be used to prognosticate. In this study, we analyze the association of NLR with gastric cancer treatment outcomes in the Eastern Indian population.Methods: We performed a retrospective analysis of hospital records of patients diagnosed with gastric cancer who underwent curative surgery in the Surgical Oncology department at our institute. All surgical and treatment details were obtained. The NLR was calculated based on the patient's differential count performed pre-operatively. Kaplan-Meier curves and Cox regression models (univariate and multivariate) were used for overall survival (OS) analysis.Results: A total of 195 patients with gastric cancer underwent surgery, of which 74 patients underwent surgery with curative intent and had complete data. The mean age was 56.5 (range 29-80) and Male to Female ratio was 2:1. The Median NLR was 2.47, based on which patients were divided into high and low-NLR groups. The 3-year OS was 55.5 and 56.2 months in the low-NLR and high-NLR group, respectively. (p ¼ 0.75; HR 1.14; CI 0.47 -2.78). Conclusions:No difference in survival among patients with low-NLR and high-NLR was found. The NLR may not be a good prognostic indicator in gastric carcinoma.Legal entity responsible for the study: The authors.