Abstract: Objective To investigate the correlation of the preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) with clinicopathological characteristics in patients with papillary thyroid cancer. Methods A retrospective study was performed to analyze the clinical data of patients with thyroid papillary carcinoma who accepted surgery treatment firstly in the Affiliated Hospital of Logistics University of PAP from January 2015 to December 2017. The relationship between NLR, PLR and SII and clinicopathological characteristics of papillary thyroid carcinoma was discussed. Results The preoperative NLR significantly correlated with bilateral carcinoma (P=0.040) and multifocality (P<0.001) in papillary thyroid cancer, but not with the age, sex, tumor size, TNM staging, extrathyroidal invasion and cervical lymph node metastasis (all P>0.05). The preoperative PLR obviously correlated with the sex (P=0.019) and cervical lymph node metastasis (P=0.048) in papillary thyroid cancer, but not with the age, tumor size, TNM staging, multifocality, Bilateral carcinoma, and extrathyroidal invasion (all P>0.05). The preoperative SII correlated with multifocality (P<0.001) and bilateral carcinoma (P=0.002) in papillary thyroid cancer, but not with the age, sex, tumor size, TNM staging, extrathyroidal invasion, and cervical lymph node metastasis in papillary thyroid cancer (all P>0.05). Conclusion The preoperative levels of NLR, PLR and SII can reflect the biological characteristics of papillary thyroid carcinoma. The increased NLR, PLR and SII levels in papillary carcinomas might correlate with the poorer histopathological profile and more aggressive clinical behavior.