Introduction: Breast cancer (BC) is a common female cancer worldwide including in Sudan. Despite the improvement in diagnosis, still more effort is needed for prognostic biomarkers. Objectives: To assess the predictive value of neutrophils-lymphocytes ratio (NLR) in BC disease-free survival (DFS) and overall survival (OS). Method: This was a retrospective hospital-based study including 65 stage-III BC female patients treated at the National Cancer Institute -University of Gezira (NCI-UG), Sudan between 1st January 2013 and 31st December 2014 and followed up to 2019. Data were retrieved from medical records and SPSS software was used for statistical analysis. X² test was used to demonstrate the association of NLR with demographic, clinicopathological and therapeutic variables. Cox regression models were used to determine the hazard ratios and 95% confidence intervals (CIs) of DFS and OS in relation to pre-treatment NLR. Results: Analysis showed that patients with high NLR had a high rate of postoperative recurrence and death. From the 65 investigated BC patients, 20 (31%) have abnormally higher than normal NLR (> 3%). Of those 31% BC patients, 70% were in the age group > 40 years old, 75% were histologically grade III, 95% were invasive ductal carcinoma (IDC) histological type, 55% were postmenopausal, 89.5% were lymph node-positive, and 70% not underwent radiotherapy. NLR was identified as an independent prognostic factor for DFS and OS in stage III BC (P < 0.05). Conclusion: It had been concluded that high NLR was associated with decreased DFS and OS and a higher rate of postoperative recurrence and death in BC.