Background and Aims Systemic inflammation is closely associated with the development of most malignant tumors. Studies of inflammation-related scores provide valid predictive information for improving the risk stratification and prognosis of patients with cancer. However, the studies to evaluate the relationship between inflammation scores and the risk of postoperative relapse in patients with gallbladder cancer (GBC) are limited. Therefore, this study was conducted to investigate the relationship between preoperative lymphocyte to C-reactive protein (CRP) ratio (LCR) and postoperative recurrence in GBC patients and establish a nomogram model to predict the risk of postoperative recurrence of GBC.Methods The clinical data of 103 patients with GBC who received surgical treatment from May 2009 to December 2021 in the No. 900 Hospital, Joint Logistics Support Force of the Chinese People's Liberation Army were retrospectively analyzed. A receiver operating characteristic curve (ROC) of LCR for predicting postoperative recurrence was drawn, and the optimal cut-off value was determined. Based on the cut-off value, the patients were divided into high LCR group and low LCR group. The differences in clinicopathologic characteristics between the two groups of patients were analyzed, and the risk factors for postoperative recurrence were determined. According to the regression coefficient of risk factors, the corresponding nomogram prediction model of postoperative recurrence in GBC patients was created and validated by calibration curve and consistency index. Survival curves were drawn by the Kaplan-Meier method, and the differences in overall survival (OS) and recurrence-free survival (RFS) between two groups of patients were compared by Log-rank test.Results The area under the ROC curve of preoperative LCR for predicting postoperative recurrence in GBC patients was 0.681 (95% CI=0.560-0.802, P<0.05) and the cut-off value was 0.275. Results of the univariate analysis showed differences in T stage, lymphnode metastasis, surgical procedure, combined hepatectomy or not, combined choledochotomy or not, surgical margin, CA19-9, CEA, CA125 and LCR between the two groups (all P<0.05). Multivariate Logistic analysis showed that T stage, CA19-9 and LCR were independent risk factors for postoperative recurrence in GBC patients (all P<0.05). The C-index of the nomogram established by integrating the risk factors was 0.736, and the calibration curve indicated that the probability of recurrence predicted by the nomogram was in good agreement with the actual observation. The Kaplan-Meier survival curve showed that the OS and RFS of patients in the high LCR group were significantly higher than those of patents in the low LCR group (both P<0.001).Conclusion LCR can be used as a new indicator for predicting the postoperative recurrence of GBC patients. The higher the preoperative peripheral blood LCR, the lower the risk of recurrence in patients. The nomogram prediction model constructed on this basis will help clinicians provide better information on individualized treatment and follow-up strategies for GBC patients.