Objective The systemic inflammatory response index(SIRI)was used to evaluate the prognosis of high-grade non-muscle invasive bladder cancer(NMIBC)patients,which provided new ideas and theoretical value for the di-agnosis and treatment of patients with high-grade NMIBC.Methods A total of 40 cases with high-grade NMIBC who un-derwent transurethral resection of bladder tumor(TURBT)in the First Affiliated Hospital of Bengbu Medical University from January 1,2019 to January 1,2020 were analyzed retrospectively.According to whether the patient has a tumor re-currence after surgery,the working subjects operated the characteristic curve(ROC)to determine the best cutoff value of SIRI and divided it into high-value group and low-value group,so as to determine the influence on the prognosis of high-grade NMIBC patients.Results The ROC curve of SIRI to predict prognosis(with or without recurrence)is drawn,and the best cut-off value of SIRI was 1.46.According to the optimal cut-off value,patients were divided into high SIRI group(SIRI≥1.46,18 cases)and low SIRI group(SIRI<1.46,22 cases).Tumor size varied in the distribution between the high and low SIRI groups.Patients with high SIRI were more likely to have a 3 cm maximum tumor diameter before sur-gery.Survival analysis showed that there were significant differences in SIRI,tumor number,and recurrence-free survival(RFS)during different size of tumors.The survival of patients with low SIRI was better than that of patients with high SIRI.Patients with single tumor were better than patients with multiple tumors,and patients with maximum tumor diame-ter less than 3 cm were better than patients with tumor diameter more than 3 cm.Cox univariate analysis confirmed that SIRI,tumor number,and tumor size were independent influencing factors for postoperative RFS in the advanced group.Cox multivariate analysis confirmed that SIRI more than 1.46 was an independent risk factor for postoperative RFS in NMIBC patients.Conclusion SIRI can be used as a risk assessment index for patients with high-grade NMIBC,which can provide new options and directions for the treatment of high-grade NMIBC.