BACKGROUND: Platelet to lymphocyte ratio (PLR) has been demonstrated as an risk and prognostic marker in many of cardiovascular diseases. Relationship between PLR and severity of carotid stenosis has been shown. The aim of our study was to investigate the relationship between PLR and all cause mortality in patients with carotid arterial disease. METODS: This retrospective study included 146 patients who had been performed selective carotid angiography. Carotid stenosis were graded by the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria. Platelet to lymphocyte ratio was calculated as the ratio of plateletes to lymphocytes. The end point of the study was all-cause mortality. RESULTS: During median follow-up of 16 months (0-65 months) 15 (10.3%) patients suffered all-cause mortality. 50 patients(34.2%) underwent carotid endarterectomy and 69 patients (47.3%) had non-carotid cardiac surgery. 38 patients (26.02%) had cerebrovascular events (stroke/transient ischemic attack) at admission. NASCET grades were not different between survivors and non-survivors. Non-survivors had significantly lower hemoglobin (Hb) levels (12.7±1.6 g/dl vs. 13.7±1.7 g/dl , p= 0.031) and they were older than survivors (74.2±8.4 years vs. 68.6±8.5 years, p=0.029). Non-survivors had significantly higher PLR values compared with survivors (190.3±85.6 and 126.8±53.8, p=0.017). In multivariate analysis, only PLR predicted all-cause mortality in patients with carotid artery stenosis. CONCLUSİON: In our study, higher PLR was associated with increased all-cause mortality.