The recent clinical studies performed to in vivo investigate the immune functions have shown that lymphocyte-to-monocyte ratio (LMR) may be considered as the more simple and synthetic biomarker to clinically analyze the immune status of patients, since the immune activation is mainly related to lymphocyte functions, whereas the monocyte-macrophage system is the main responsible for chronic inflammationrelated immune suppression. Cancer progression has been proven to be associated with a progressive decline in LMR values, while the behavior of LMR in autoimmunity is more controversial. The present preliminary study was planned to analyze LMR values in cancer patients, and in patients with autoimmune diseases in relation to the different disease phases. The study included 149 cancer patients (non-metastatic disease: 68; metastatic disease: 81), 51 patients with autoimmune pathologies (remission phase: 37; acute phase: 14), and in 100 healthy subjects as controls. LMR mean values observed in metastatic patients were significantly lower than those found either in patients without metastases, or in controls. Patients with autoimmune diseases in remission phases showed higher values of LMR than controls, without, however, significant differences, whereas LMR mean values observed in patients during the acute phase of disease were significantly lower with respect to both controls and patients in remission phase. These results seem to suggest that the evidence of abnormally low values of LMR may deserve a negative prognostic significance in both cancer and autoimmunity. This paradoxical evidence may be explained only by investigating the main inflammatory and anti-inflammatory cytokines responsible for the regulation of the immune functions, including TGF-beta, IL-2, IL-17, IL-6, and IL-12, whose detection will be the aim of future clinical studies.