Background and Aims Pancreatic cancer is one of the highly malignant solid tumors, and most patients are diagnosed at the locally advanced or late stage due to the lack of early symptoms. Therefore, exploring preoperative prognostic markers is crucial for making diagnosis and treatment strategies in clinical practice. Currently, the relationship between preoperative neutrophil-to-lymphocyte ratio (NLR) and the postoperative prognosis of pancreatic cancer patients is still controversial. This study was conducted to investigate the association of preoperative NLR with the postoperative survival benefits of pancreatic cancer patients, as well as its prognostic value through a Meta-analysis.Methods The studies concerning the relationship between preoperative NLR values and postoperative overall survival (OS) and disease-free survival (DFS) of pancreatic cancer patients were collected by searching PubMed, Cochrane Library, Web of Science, CNKI, VIP, and Wanfang databases. The search was limited from the inception of the databases to March 31, 2022. Two reviewers independently screened and included the literature, and then extracted data, and assessed the risk of bias in the included studies. Revman 5.4 and Stata 16.0 software were used to combine the hazard ratio (HR) and 95% confidence interval (CI), and the corresponding effect model was selected based on heterogeneity. Sensitivity analysis was performed on the included studies, and the Egger regression test was used to determine if there was significant publication bias in the included literature.Results A total of 25 retrospective studies with 4 796 subjects were included. Of these, 24 articles reported the relationship between NLR and postoperative OS, and 6 articles reported the relationship between NLR and postoperative DFS. The NLR cutoff values and sample sizes in the included retrospective studies were 2.0-5.0 and 28-442, respectively, and the NOS scores of the included studies were between 6-9. Meta-analysis results showed that pancreatic cancer patients with high preoperative NLR levels had significantly shortened postoperative OS (HR=1.24, 95% CI=1.16-1.33, P<0.000 01) and DFS (HR=1.39, 95% CI=1.21-1.60, P<0.000 01). Subgroup analyses based on different NLR cutoff values also showed that high preoperative NLR levels were significantly associated with shortened postoperative OS and DFS (all P<0.05). As revealed by the sensitivity analysis results, the pooled effect sizes for OS and DFS showed no significant changes. Publication bias analysis showed no significant publication bias in the included studies.Conclusion Pancreatic cancer patients with high preoperative NLR levels have shortened postoperative OS and DFS compared to those with low preoperative NLR levels. Preoperative NLR value is a potential biomarker for evaluating the prognosis and survival benefits of pancreatic cancer patients. Due to limitations in the number and quality of studies, further high-quality research is needed to verify the above conclusions.