Introduction: A measurement of neutrophil to lymphocyte ratio (NLR) and of platelet to lymphocyte ratio (PLR) has been found to be one of the markers of tumour burden for patients with carcinoma ovary. It has been noted that higher the NLR and PLR values, lower is the overall and recurrent free survival. Thus, we undertook the present study to analyse the role of NLR and PLR as a predictor of outcome in advanced high grade serous adenocarcinoma of ovary. Materials and Methods: A retrospective study was conducted from January 2018 to December 2019 at a tertiary level regional cancer institute of Northeast India including women with high grade epithelial ovarian cancer. A total of 100 cases were analysed and neutrophil is to lymphocyte ratio (NLR) and platelet is to lymphocyte ratio (PLR) was calculated for all patients; pre and post treatment. For comparison of NLR and PLR values pre and post treatment, chi square test was used and p value of less than 0.05 was considered significant. Kaplan-Meier curves were used for comparison of recurrence to survival percentage at 1,3 and 5 years based on pre NACT NLR and PLR and pre-recurrence NLR values. Results: At initial presentation, the NLR and PLR values were calculated for all 100 patients and it was seen that NLR was less than 8 in 35% cases, 8 to 11 in 15%and more than 11 in 50% of the study population.All patients received 3 to 4 cycles of neo-adjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS). Post IDS, NLR was less than or equal to 1 in 61% and more than 1 in 39% cases. The PLR was found to be less than or equal to 5 in 53% and more than 5 in 47% cases. All patients had recurrence within 24 months of completion of treatment.It was seen that when NLR values (post NACT) was more than 11, early recurrence was seen in 61% cases and 35% cases showed late recurrence. This comparison was significant (p value: 0.004).Conclusion:The NLR has been proposed to be significant prognosis predictors for ovarian cancers. Yet, the cutoff value of the NLR is inconsistent instudies, which reduces its clinical applicability. In the present study the chosenmedian cut off value of pre NACTNLR > 11(HR:2) and PLR> 59 (HR:1.5) and a pre recurrence NLR> 9 (HR:2.6) had a significant impact on the post recurrence survival. A pre recurrence NLR> 9 was also a poor predictor of survival.