Background: Neutrophils play a critical role in the immune response, platelets for regulating coagulation and inflammatory responses. This study aims to investigate relationship between Neutrophil Platelet Ratio (NPR) and severity of sepsis, that can be used as biomarker for predicting severity and mortality of sepsis patients. Methods: This study was a cohort-retrospective study at Wahidin Sudirohusodo Hospital. We included patients ages over 18 years with sepsis and septic shock diagnosed. NPR is calculated by dividing neutrophil by platelet, data were analyzed using Mann-Whitney test. Results: Data analysis was performed on 66 subjects with Sepsis and Septic Shock patients (33 each group). Average NPR in sepsis patients was 0.110.12 and septic shock patients 0.110.20 with p-value of 0.455 indicates that no significant difference. The average NPR in patients who survived was 0.110.10, while patients who didn’t survive was also 0.110.20 with p-value 0.09. Relationship between NPR and mortality in patients during the 7-day treatment with p-value of 0.002, means NPR has a relationship with risk of death in sepsis patients in 7-day care. Conclusion: Our study found that High NPR is related to mortality within 7 days treatment, but NPR at admission hasn’t been proven as a predictor of sepsis severity.