Purpose To evaluate the prognostic value of preoperative hemoglobin-lymphocyte-neutrophil ratio (HLNR) and hemoglobin-lymphocyte-platelet ratio (HLPR) for predicting tumor recurrence at control cystoscopy in patients with non-muscle invasive bladder cancer (NMIBC) and to compare these indices with lymphocyte-neutrophil ratio (LNR) and platelet-lymphocyte ratio (PLR).Methods We retrospectively analyzed 180 patients who underwent transurethral resection for pathological Ta/T1 urothelial bladder tumors. ROC curve analysis was used to assess the predictive performance of each index, and factors associated with recurrence were evaluated using univariate and multivariate logistic regression. An exploratory composite risk score integrating European Organisation for Research and Treatment of Cancer (EORTC)-like clinicopathological factors with HLNR was developed.Results HLNR showed the highest predictive accuracy with an AUC of 0.75 (95% CI: 0.68–0.82), whereas HLPR, LNR, and PLR had AUC values of 0.65, 0.61, and 0.58, respectively. An optimal cut-off of ≥ 2.0 for HLNR yielded 72% sensitivity and 70% specificity (p < 0.001), and high HLNR (≥ 2.0) remained independently associated with a lower risk of recurrence in multivariate analysis (OR 0.34; 95% CI: 0.18–0.63; p < 0.001). Although high HLPR (≥ 0.45) was protective in univariate analysis (OR 0.55; p = 0.031), it did not retain independent significance in the multivariate model (p = 0.209).Conclusion Preoperative HLNR is significantly and independently associated with tumor recurrence at control cystoscopy in patients with NMIBC. Integration of HLNR into EORTC-like risk models appears promising, but its prognostic value should be validated in prospective, multicenter studies.