© West Indian Medical Journal 2022. This is an article published in open access under a Creative Commons Attribution International licence (CC BY). For more information, please visit https://creativecommons.org/licenses/by/4.0/deed.en_USObjective: To determine the value of neutrophil-lymphocyte ratio for predicting high-grade dysplasia among patients with neoplastic colorectal polyp. Method: We evaluated 30 patients with non-neoplastic polyp, 61 patients with neoplastic polyp (32 with high-grade dysplasia/29 without high-grade dysplasia), and 30 patients with normal colonoscopy as control group. Mean platelet volume, red cell distribution width, neutrophil and lymphocyte levels were recorded and neutrophil-lymphocyte ratio was calculated. Results: Mean neutrophil-lymphocyte ratio of patients with neoplastic polyp were higher than patients with non-neoplastic polyp and control group (2.56 ± 1.47, 1.77 ± 0.44, 1.76 ± 0.62, retrospectively) (p = 0.001). Mean platelet volume of patients with neoplastic polyp (8.76 ± 1.06) was lower than patients with non- neoplastic polyp (9.50 ± 1.27) and control group (10.96 ± 0.83) (p < 0.001). Mean neutrophil-lymphocyte ratio of patients with high-grade dysplasia (3.03 ± 1.88) was significantly higher than patients without high-grade dysplasia (2.14 ± 0.77) (p = 0.022). The cut-off value of neutrophil-lymphocyte ratio to predict the presence of high-grade dysplasia was 2.044 (sensitivity: 69%, specificity: 68%). Conclusion: Neutrophil-lymphocyte ratio, which is a simple non-invasive index can predict high-grade dysplasia and neoplastic polyp. Although mean platelet volume and red cell distribution width are not useful for identifying high-grade dysplasia in patients with colorectal polyp, mean platelet volume may be associated with neoplastic polyp.