Many studies reported the prognostic value of neutrophil to lymphocyte ratio (NLR) for bladder cancer, however, these studies presented conflicting results. In the present study, we intended to comprehensively investigate the associations between pretreatment NLR and overall survival (OS), cancer-specific survival (CSS)/disease-specific survival (DSS), and recurrence-free survival (RFS) through meta-analysis. The values of hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) from 9 studies with 2,300 patients were extracted and combined. The results suggested that increased NLR was correlated with shorten OS (HR=1.48, 95% CI=1.05-2.09, P=0.027) and CSS/DSS (HR=1.58, 95% CI=1.01-2.46, P=0.044), but had no correlation with RFS (HR=1.41, 95% CI=0.92-2.17, P=0.112). Furthermore, subgroup analyses stratified by different clinicopathological factors demonstrated that elevated NLR still predicted poor OS in large sample size studies and held prognostic value for RFS when NLR <= 2.5. In conclusion, the current study identifies NLR as a prognostic factor for poor OS and CSS/DSS, but not for RFS in bladder cancer.