Objective: To investigate the impact of the preoperative peripheral blood neutrophil-to-lymphocyt ratio (NLR) on postoperative prognosis of patients with intrahepatic cholangiocarcinoma (ICC). Methods: Clinicopathologic data of 96 ICC patients undergoing partial hepatectomy were collected. Based on the preoperative peripheral blood NLR, the patients were divided into low NLR group (NLR<2.5) and high NLR (NLR≥2.5) group. The overall survival rate and relapse-free survival time between the two groups were compared, and risk factors that would influence the prognosis of these patients were determined by univariate and multivariate analyses. Results: The 1,3 and 5-year overall survival rate for the entire group was 48%, 35% and 30%, which for high NLR group was 37%, 26% and 22%, and for low NLR group was 63%, 49% and 42% respectively, and the difference between the two groups had statistical significance (P=0.016). The median relapse-free survival time for the entire group was 10.2 months, which for high NLR group and low NLR group was 8.9 and 14.6 respectively, and the difference between the two groups had statistical significance (P=0.045). Univariate analysis showed that the overall survival of the patients was associated with the preoperative NLR along with the factors that included the preoperative CA19-9 and CEA level, lymph node metastases, tumor number and maximal size, adjacent organ invasion, distant metastasis, TNM stage and type of surgery (all P<0.05); multivariate analysis revealed that the preoperative NLR, lymphatic metastasis, and tumor number and maximal size were the independent risk factors for the overall survival of the patients (all P<0.05). Univariate analysis suggested that the relapse-free survival of the patients was related to the preoperative NLR together with the factors that included the preoperative CA19-9 and CEA level, lymph node metastases, tumor number and maximal size, distant metastasis, TNM stage and type of surgery (all P<0.05); multivariate analysis demonstrated that the lymphatic metastasis, tumor number and distant metastasis were the independent risk factors for the relapse-free survival of the patients (both P<0.05). Conclusion: Preoperative peripheral blood NLR can be used as a prognostic predictor of ICC patients, and those with high NLR face a poor prognosis.