The implementation of new markers of bacterial and viral infection into clinical practice is hindered by their costs. In this study we assessed the potential use of the neutrophil to lymphocyte count ratio (NLCR) in crimean conga hemorraghic fever (CCHF). NLCR values were measured in total 104 patients with CCHF with 77 patients in whom bleeding was observed and 27 patients without bleeding observed and in 61 healthy adults. NLCR values of patients were measured in the first and 3rd days in which the patients admitted to the hospital. Median NLCR value was found as 4.02 in the patient group on the 1st day and 2.02 on the 3rd day, while this value was 4.10 in the healthy adults. NLCR values of the 3rd day were found as 1.16 (0.05-3.401 in the patients with bleeding and 2.32 (0.35-19.45) in the patients without bleeding (p<0.01). NLCR value seems to be a marker guiding in determination of the clinical course and treatment from the 3rd day of the contact with ticks.