Abstract: Objective To investigate the relationship between preoperative and postoperative changes of neutrophil-lymphocyte ratio（NLR） and prognosis of gastrointestinal stromal tumor. Method The clinical and pathological data of 228 patients with gastrointestinal stromal tumors were analyzed retrospectively. They were divided into two groups according to the preoperative and postoperative changes of NLR. The relationship between preoperative and postoperative NLR changes and clinicopathological features and disease-free survival of patients with gastrointestinal stromal tumors were analyzed. Results There were no significant differences in gender, age, tumor location, and adjuvant treatment with imatinib after surgery in the NLR-increased group and the NLR-decreased group (P>0.05). The differences in risk, mitotic figures, Ki-67 proliferation index, and preoperative NLR were statistically significant (P<0.05). Univariate analysis suggested that the following factors directly affected the patient’s disease-free survival : tumor size, risk, Ki-67 proliferation index, postoperative imatinib adjuvant therapy, preoperative NLR, preoperative and postoperative NLR changes. Cox multivariate risk regression showed that tumor size, tumor risk, preoperative NLR, preoperative and preoperative NLR changes were independent factors affecting disease-free survival in patients. Conclusion Preoperative and postoperative changes in NLR are independent factors affecting the prognosis of gastrointestinal stromal tumor, and it is expected to be an effective evaluation index for predicting the prognosis of gastrointestinal stromal tumor.