Background: Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are markers of inflammation and have been demonstrated as important prognostic factors in various benign disorders and malignancies. Recently, there have been reports on the utility of NLR and PLR as prognostic factors in patients with metastatic renal cell cancer (RCC) but there is a little data to determine their role in metastatic papillary RCC (pRCC). We aim to evaluate the significance of NLR and PLR in determining overall survival (OS) in metastatic pRCC patients. Methods: Retrospective evaluation of the medical records of patients with metastatic pRCC seen at National Cancer Institute (2000-2014) was undertaken. Patient demographics, tumor characteristics and outcomes were studied. NLR > 5 and PLR > 210 were considered elevated based on previous reports in literature. Kaplan-Meier Survival analysis was done to estimate OS. Results: Out of a total of 106 patients with metastatic pRCC seen during the study time period, 68 had data for NLR and PLR between the time of diagnosis of metastasis and initiation of systemic therapy. Mean age at the time of diagnosis of metastatic disease was 49.7 (±14.3) years. NLR > 5 and PLR > 210 was found in 12 (17.6%) and 26 (38.2%) patients. There was no difference in mean age, gender, histologic subtypes and stage between the patients with elevated NLR vs NLR ≤ 5 or those with elevated PLR vs PLR ≤ 210. Fifty (73.5%) patients died during median follow up of 34.1 mon. All 12 patients with elevated NLR and 24 (92.3%) patients with elevated PLR died. Median estimated OS of patients with elevated NLR was significantly worse than the patients with NLR ≤ 5 (19.2 vs 46.5 mon, p = 0.001). Similarly, elevated PLR portended worse OS (27.3 vs 49.0 mon, p = 0.004). Median OS of patients with neither, either one or both markers elevated was 50.7, 33.0 and 19.2 mon respectively (p = 0.002). Conclusions: To our knowledge, this is the first report evaluating the prognostic impact of NLR and PLR in metastatic pRCC. Elevated PLR and NLR significantly impact OS in these patients. If validated in larger cohorts, it might be reasonable to incorporate NLR and PLR in nomograms predicting OS in metastatic pRCC.