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Original Article, Background: Neutrophil-lymphocyte ratio (NLR) is associated with the inflammatory status of patients with some cancers. We tested the hypothesis that postoperative NLR (post-NLR) was associated with outcomes in patients with stage II/III gastric cancer. Methods: We retrospectively analyzed data from 193 patients with stage II/III gastric cancer who underwent curative gastrectomy at St. Luke's International Hospital between 2000 and 2012. All patients underwent baseline staging, including blood testing, computed tomography, and endoscopic biopsy. The association of post-NLR with clinical outcomes was analyzed by univariate and multivariate analyses. Results: Average age was 67.7 (95% confidence interval, 43.5 - 91.9) years, and most patients were male. After surgery, 92 (47.7%) patients underwent adjuvant chemotherapy. Median follow-up time was 78.4 (95% confidence interval, 70.3 - 86.6) months. In univariate analyses, age, stage, preoperative NLR, baseline carbohydrate antigen (CA)19-9 level, postoperative white blood cell count, postoperative hemoglobin level, post-NLR, and adjuvant chemotherapy were associated with overall survival (OS). In multivariate analyses, age (p<0.01), stage (p<0.01), and post-NLR (p<0.01) were associated with OS. When the post-NLR cutoff value was set at 3, outcomes were worse for patients with high post-NLR than for those with low post-NLR (p<0.001). Conclusions: High post-NLR was associated with poor OS and recurrence-free survival in patients with locally advanced gastric cancer, which indicates that post-NLR might be a useful marker for individualized therapy.