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Introduction: This study aimed to investigate pre-procedural (Neutrophil to Lymphocyte Ratio) (NLR) in patients with (Left Main Coronary Artery) (LMCA) disease and to identify a relevant NLR value related to mortality after percutaneous intervention in unprotected LMCA disease. Patients and Methods: Seventy-one patients diagnosed with unprotected LMCA disease were divided into two groups according to their mortality rates: survivors (n= 56, 78%) and non-survivors (n= 15, 22%). The mean follow-up duration was 26.0 ± 24.8 months, and all-cause mortality was considered as an endpoint. Results: The non-survivor group had higher NLR values [3.23 (2.31-4.01) vs. 5.82 (2.92-14.99), p= 0.026] compared to the survivor-group. ROC analysis revealed an NLR cut-off value of 5.24 for predicting all-cause mortality. During follow-up, the group with high NLR values was associated with a significantly higher rate of all-cause mortality rate [6 (10.5%) vs. 9 (64.3%), p< 0.001] compared to the low NLR group. In multivariate analysis, the NLR (OR= 1.695; 95% CI= 1.124-2.556; p= 0.012) was found to be independent predictors of mortality. Conclusion: NLR is the independent predictor of all-cause mortality in unprotected LMCA disease. As far as we know, this study is the first study investigating the prognostic value of NLR in patients with unprotected LMCA disease stenting.