Objective To explore the predictive value of preoperative C⁃reactive protein⁃albumin ratio for early recurrence in patients with radial gastrectomy. Methods A total of 160 patients receiving radical gastrectomy in our hospital from May 2016 to May 2018 were retrospectively analyzed. According to whether recurrence occurred within 2 years of follow⁃up, patients were divided into recurrent group (n=34) and non⁃recurrent group (n=134). The clinical characteristics and related hematological indicators were compared between two groups. The efficacy of the above indexes in predicting early recurrence was analyzed. Results The tumor diameter (t=-2.326，P=0.021), the lymphovascular invasion rate(χ2=6.674，P=0.010)and lymph node metastasis(χ2=617.617，P<0.001) of the recurrent group were significantly higher than those of the non⁃recurrent group.However, there were no statistically significant differences between the two groups in age, body mass index (BMI), gender, surgical method, digestive tract reconstruction method and pathological type (P>0.05). With the comparison of preoperative hematological indicators between the two groups, it showed that systemic immune⁃inflammatory index(t=-2.951， P=0.004), neutrophil⁃lymphocyte ratio(t=-2.245，P=0.026), platelet⁃lymphocyte ratio(t=-2.885，P=0.004)and C⁃reactive protein⁃albumin ratio(t=-3.960，P<0.001)were significantly higher in the recurrent group than in the non⁃recurrent group. When the CAR threshold is set at 0.142, the specificity, sensitivity and AUC are 0.690, 0.962 and 0.719 respectively. Conclusion Preoperative CAR can effectively predict the risk of early recurrence after radical gastrectomy for gastric cancer.