Abstract: Objective To investigate the effects of neutrophil to lymphocyte ratio (NLR) in prognosis of patients with stageⅣ gastric cancer (AGC) treated with chemotherapy. Methods From January 2010 to December 2013， clinical data about 88 patients diagnosed with metastatic AGC who were treated with first-line chemotherapy of XELOX or DCF regimen in our hospital were analyzed retrospectively. NLR were calculated from the last blood routine before the first chemotherapy. Taking the median value 3 as the cutoff， patients were divided into low NLR group (NLR≤ 3, n=41) and high NLR group (NLR＞ 3, n=47). The clinical outcomes of patients in two groups were compared. Results Both progression-free survival (PFS) and overall survival (OS) of patients in low NLR group were significantly higher than high NLR group (8.17 months vs 6.47 months, P=0.019; 21.53 months vs 14.03 months, P=0.014). In multivariate Cox analysis， NLR showed a significant association with PFS (HR=1.766; 95% CI: 1.089-2.862; P=0.021)， but it had no effect on the OS (P=0.079). Conclusion NLR is a potential prognostic indicator for stage Ⅳ gastric cancer patients undergoing palliative chemotherapy. It is an independent prognostic factor for PFS， but significant association between NLR and OS is not found in this study.