Aim: Assessing the diagnostic efficacy of combining alpha-fetoprotein (AFP) with the neutrophil-to-lymphocyte (NLR) ratio in comparison to using AFP alone for detecting hepatocellular carcinoma (HCC). Method: Sixty patients new with HCC diagnosed as per EASL guidelines and 60 controls with chronic liver disease were studied. Serum AFP levels and the NLR of study participants were determined. The diagnostic values of these variables were assessed and compared by ROC curves. Results: For diagnosing HCC, The AFP's C-statistic stood at 0.941 (p=0.000), demonstrating significance. With an optimal cut-off of 8.4, it showed a sensitivity of 93.3% and a specificity of 83%. Conversely, the NLR's C-statistic was 0.623 (p=0.101),lacking significance. Utilizing a cut-off of 4.4, its sensitivity and specificity for diagnosing hepatocellular carcinoma (HCC) were 63.3% and 60%, respectively. Notably, the difference in C-statistics between AFP and NLR was significant (p=0.0007), whereas the combination of AFP and NLR didn't yield a significant difference compared to AFP alone (p=0.54). Conclusion: NLR was not useful for an early diagnosis of HCC. AFP was a reliable diagnostic marker for HCC but AFP in combination with the NLR demonstrated the highest diagnostic accuracy. Thus, this combination can be used for early diagnosis of HCC, ensuring a better outcome.