Objective To investigate the value of neutrophil-lymphocyte ratio NLR and geriatric Nutritional risk index GNRI in predicting the prognosis of patients with colorectal cancer. Method A total of 103 patients with colorectal cancer who were diagnosed and treated in Wuhan Red Cross Hospital from May 2019 to January 2021 and followed up to December 2023 were selected as the study objects and set as the colorectal cancer group and 52 healthy subjects were selected as the control group during the same period. Compare the changes of NLR and GNRI. The changes of NLR and GNRI in colorectal cancer patients with different pathological characteristics were compared. Kendall′ s tau - b method was used to analyze the correlation between NLR GNRI and clinical features. Cox regression risk model was used to analyze the effects of NLR and GNRI on the prognosis of colorectal cancer patients. The combined parameters of NLR and GNRI were constructed by Logistic regression and receiver operating characteristic ROC curves were drawn to analyze the efficacy of NLR GNRI and the combined prediction of prognosis. Result The NLR and GNRI in colorectal cancer group were lower than those in control group P<0. 05 . The progression-free survival of 103 patients with colorectal cancer was 30. 98±8. 27 the overall survival was 32. 91±6. 09 months the 3-year progression-free survival rate was 71. 84% 74 / 103 and the 3-year overall survival rate was 77. 67% 80 / 103 . There were statistically significant differences in NLR and GNRI among colorectal cancer patients with different age differentiation degree clinical stage lymph node metastasis and albumin P< 0. 05 . Kendall′s tau-b correlation analysis showed that NLR was positively correlated with age differentiation clinical stage and lymph node metastasis of colorectal cancer patients and negatively correlated with albumin P<0. 05 . GNRI was negatively correlated with age differentiation and clinical stage of colorectal cancer patients and positively correlated with albumin P<0. 05 . Cox regression risk model analysis showed that the increase of NLR and the decrease of GNRI were independent influencing factors for 3-year disease-free survival and overall survival of colorectal cancer patients P<0. 05 . ROC curve analysis showed that the AUC values of NLR GNR and the combination of NLR and GNR were 0. 732 0. 693 and 0. 808 respectively P<0. 05. Sensitivity was 69. 60% 60. 90% 65. 20%. The specificity was 93. 70% 96. 20% and 98. 80% . Conclusion The increase of NLR and the decrease of GNRI have adverse effects on the prognosis of colorectal cancer patients and dynamic observation of their changes is conducive to providing guidance for clinical treatment and prognosis assessment.