Objective To investigate the relationship between neutrophil to lymphocyte ratio NLR platelet to lymphocyte ratio PLR and muscle mass loss in patients with primary liver cancer. Method 328 primary liver cancer patients were included in a retrospective study. Cross sectional skeletal muscle index SMI of the third lumbar vertebra was Computed with Computed Tomography CT . The risk factors of muscle loss were analyzed by Logistic regression and the optimal cut-off values of NLR and PLR were determined according to receiver operating characteristics ROC curve. The area under the curve AUC was used to evaluate the predictive effect of each indicator on muscle loss in primary liver cancer patients. Result 328 primary liver cancer patients included 269 male patients and 59 female patients and the incidence of total muscle mass loss was 61. 89%. ROC curve showed that the optimal cut-off values of NLR and PLR were 4. 04 and 163. 01 respectively and the AUC values were 0. 629 95%CI = 0. 569-0. 690 P < 0. 001 0. 608 95%CI = 0. 546- 0. 670 P = 0. 001 the AUC value of primary liver cancer muscle mass loss predicted by NLR combined with PLR was 0. 643 which was better than that predicted by NLR and PLR alone. NLR combined with PLR score 0 score NLR≤4. 04 and PLR≤163. 01 Score NLR > 4. 04 or PLR > 163. 01 2 scores NLR > 4. 04 and PLR > 163. 01 could further stratify the loss of muscle mass in primary liver cancer patients and the difference between groups was statistically significant χ2 = 24. 262 P < 0. 001 . Conclusions NLR and PLR are independent predictors of muscle mass loss in primary liver cancer patients and their combination is more likely to identify primary liver cancer patients with muscle mass loss.