Aim: The neutrophil-lymphocyte ratio (NLR) is a parameter that has been shown to be effective as a prognostic marker in many solidtumors. It is aimed to investigate NLR and the systemic immune-inflammation index (SII) in predicting the overall survival and lymphnode positivity in bladder cancer (BC).Methods: The retrospective study included patients that underwent radical cystoprostatectomy/radical cystectomy (RC) due to muscleinvasive bladder cancer (MIBC), high-grade T1 BC, or carcinoma in situ in our clinic between January 2010 and March 2020. All thepatients had no history of preoperative metastasis, lymph nodes, chemotherapy, hematological malignancies, and preoperative urinarytract infection. Data on neutrophil, lymphocyte, platelet, and hemoglobin levels and total white blood cell counts were retrieved fromclinical records and data on disease stage and lymph node positivity were retrieved from pathology reports. Follow-up times andsurvival times were recorded.Results: The 213 patients comprised 196 (92%) men and 17 (8%) women with a mean age of 63.17±11.25 years. Lymph nodepositivity was detected in 49 (23%) patients. The mean overall survival time was 75.04, 63.77, and 84.4 months in all patients, patientswith lymph node positivity, and patients with lymph node negativity, respectively. No significant difference was found between patientswith lymph node positivity and negativity with regard to NLR and SII values (p=0.975 and p=0.745, respectively). In the receiveroperating characteristics (ROC) analysis NLR and SII had no significant effect in predicting lymph node positivity [Area under the ROCcurve (AUC) 0.499 (95% confidence interval (CI): 0.403-0.594) and AUC 0.485 (95% CI: 0.394-0.575), respectively] and in predictingoverall survival [AUC 0.423 (95% CI: 0.346-0.501, p=0.056) and AUC 0.435 (95% CI: 0.357-0.514, p=0.107), respectively].Conclusion: The results indicated that SII and NLR are not sufficient to predict lymph node positivity and survival in patients withorgan-confined BC.