Objective To investigate the short-term prognostic value of serum albumin (Alb) and neutrophil-to-lymphocyte ratio (NLR) in patients with traumatic intracerebral hemorrhage (TICH).Methods A total of 286 patients with TICH who were admitted to The Third People's Hospital of Hainan Province were divided into survival group (n=229) and death group (n=57) according to the 28-day outcome. The patients were divided into mild group (n=94,<4 points), moderate group (n=120,4-15 points), and severe group (n=72,>15 points) using the National Institutes of Health Stroke Scale (NIHSS). The changes in serum Alb and NLR at 1, 3, and 7 days after admission were compared between the groups. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic values of serum Alb and NLR at each time point in predicting death in patients with TICH.Results Compared with the death group, the survival group had a significantly higher serum Alb level (33.80±5.74 vs 38.26±6.13,P<0.05; 28.24±4.62 vs 42.35±7.40,P<0.05; 21.73±4.15 vs 46.28±7.85,P<0.05) and a significantly lower NLR (5.94±2.26 vs 4.38±1.36,P<0.05; 7.15±2.40 vs 3.34±1.27,P<0.05; 8.62±3.24 vs 2.13±0.91,P<0.05) at 1, 3, and 7 days after admission. Compared with the mild group and moderate group, the severe group had a significantly lower serum Alb level and a significantly higher NLR at 1, 3, and 5 days after admission (all P<0.05). ROC curves showed that the optimal cut-off values of serum Alb and NLR at 3 days after admission for predicting death in patients with TICH were 31.52 g/L and 5.27, respectively. The area under the ROC curve of a combination of the two indices for predicting death in patients with TICH was 0.925 (95% confidence interval:0.861-0.975), with sensitivity and specificity of 93.0% and 87.5%, and was significantly higher than that of serum Alb[0.836 (0.780-0.893)]or NLR[0.851 (0.782-0.903)] alone. Correlation analysis showed that serum Alb level was negatively correlated with NLR and NIHSS score (r=-0.827, P<0.01;r=-0.724,P<0.01), and NLR was positively correlated with NIHSS score (r=0.775,P<0.01).Conclusions Serum Alb and NLR are correlated with the severity of TICH, and a combination of them at 3 days after admission has a higher predictive value for the outcome of patients with TICH.