Objective: to explore the Neutrophil/Lymphocyte Ratio in peripheral blood (Neutrophil/lymphocyte ratio) The diagnostic value of combined detection of NLR and Urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL) for hepatorenal syndrome. Methods: 112 patients with decompensated liver cirrhosis admitted to our hospital from June 2023 to October 2024 were selected as the research subjects. According to the diagnostic criteria of hepatorenal syndrome in the International Club of Ascites (ICA) in 2015, the patients were divided into the study group (with hepatorenal syndrome, n=34) and the control group (without hepatorenal syndrome, n=78). Detect and compare the levels of NLR in peripheral blood and NGAL in urine between the two groups. Peripheral blood NLR and urine NGAL were brought into the Logistic regression equation for calculation to analyze the risk factors influencing decompensated liver cirrhosis complicated with hepatorenal syndrome. To analyze the diagnostic value of peripheral blood NLR, urine NGAL and their combination for decompensated liver cirrhosis complicated with hepatorenal syndrome. Results: The levels of NLR in peripheral blood and NGAL in urine of the study group were significantly higher than those of the control group (P<0.05). Peripheral blood NLR and urine NGAL were brought into the Logistic regression equation for calculation. It was found that both peripheral blood NLR and urine NGAL were influencing factors for judging decompensated liver cirrhosis combined with hepatorenal syndrome, with OR > 1 (P<0.05). The AUC (95%CI), sensitivity and specificity of the combination of peripheral blood NLR and urinary NGAL in decompensated liver cirrhosis complicated with hepatorenal syndrome were 0.861 (0.778-0.943), 0.895 and 0.854, respectively. All were significantly higher than the single diagnoses of peripheral blood NLR and urinary NGAL (P<0.05). Conclusion: Peripheral blood NLR and urine NGAL have important diagnostic value in whether liver cirrhosis in the decompensated stage is complicated with hepatorenal syndrome, and the combined indicators of the two have higher diagnostic value.