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Objective To investigate platelet-to-lymphocyte ratio (PLR) in patients with rheumatoid arthritis (RA) and its correlation with disease activity. Methods 200 patients with rheumatoid arthritis (RA) were divided into patients with RA activity (n=86) and RA non activity (n=114). 100 healthy people were also enrolled into our study. Their clinical and biochemical data were collected. Between group comparisons made include PLR, high-sensitivity reactive protein (hs-CRP), anti-cyclic citrullinated peptide (CCP) antibodies, erythrocyte sedimentation rate (ESR), immunoglobulin, complement 3 (C3), complement 4 (C4) and rheumatoid factor (RF). Logistic regression was used to evaluate the association between PLR and RA disease activity. Results Levels of PLT, PLR, hsCRP, anti-CCP antibodies, ESR, C3, C4 and RF were significantly higher in the RA activity group compared with those of the RA non activity group and the control group (P<0.05), and were significantly higher in the RA non activity group than the control group (P<0.05). Logistic regression analysis showed that after adjusted for hsCRP, anti-CCP antibodies, ESR, C3, C4 and RF, PLR [OR=3.235(95% CI 1.997-5.894), P=0.008] was an independent risk factor of the disease activity of RA. According to the analysis of ROC curves, the area under the curve (AUC) of PLR was 0.804 (95% CI 0.738-0.869, P=0.006) and the cut off value of PLR for predicting the disease activity of RA was set at 120.37, with the sensitivity of 80.20% and the specificity of 68.60%. Conclusion PLR was a new inflammatory marker which could be used to assess disease activity in patients with RA. [ABSTRACT FROM AUTHOR]