Purpose: Neutrophil-to-lymphocyte ratio (NLR) was evaluated as a potential prognostic factor in patients with myelodysplastic syndrome (MDS). Materials and Methods: Between December 2009 and April 2014, 14 female (35%) and 26 male (65%) MDS patients who were followed up in our hematology clinic were included in the study for NLR during diagnosis. Division was into two groups according to the NLR, and the correlation with mortality was evaluated. The prognostic significance of NLR regarding treatment outcome was also evaluated with adjustment for known confounding risk factors. Results: The mortality rate of the patient group was 55%, and median survival was 18 months. There was no significant correlation between mortality and NLR at a median value of 1.8 (p=0.75). Thrombocytopenia was observed to increase mortality (p=0.027), and there was a significant correlation between mortality and pancytopenia (p=0.017). Conclusions: This first study of NLR and mortality did not show any significant correlation. In centres with limited access to genetic evaluation for the presence of pancytopenia and/or thrombocytopenia at the time of diagnosis, a platelet level less than 50x10(9)/l may be poor prognostic markers in MDS patients.