Major burns are a type of trauma with high mortality risk. Therefore, an accurate predictor of mortality indicators is needed in burn patients. This study used an analytical observational study design with a retrospective case-control approach. One such indicator is the neutrophil-lymphocyte ratio which was studied further in this study. Subjects included 60 burn patients with 30 survivors and 30 mortalities. The sex characteristics of the subjects were predominantly male (70%), with a median age of 38.5 (IQR 30.5 – 52.5) ​​years. Fire (68.3%) was the most common cause of burns. The median neutrophil-lymphocyte ratio decreased from day 1 (median 15.6, IQR 10.1–21.7) to day 3 (median 6.7, IQR 4.4 – 11.8). However, there was a different pattern in which the value of the neutrophil-lymphocyte ratio was found to increase on day 3 in the mortality group. The binomial logistic regression test found that the neutrophil-lymphocyte ratio value greater than or equal to 10 on the 3rd day was significantly associated with mortality risk with an aOR of 13.91 (95% CI 1.77 – 109.47). The conclusion is that A high neutrophil-lymphocyte ratio at day three can be used as a predictor of mortality in major burn patients.