Objective To study the predictive value of the Naples prognostic score (NPS) on colorectal cancer patients' survival. Methods The clinical and laboratory data of 80 patients with colorectal cancer diagnosed and treated in our hospital from May 2016 to May 2019 were retrospectively analyzed. According to the NPS score, the patients were divided into two groups with high and low expression. Kaplan-Meier survival analysis were used to analyze the difference in survival prognosis of patients with different NPS scores. Univariate and multivariate Cox regression analysis were used to analyze the risk factors affecting the prognosis of colon cancer patients. The receiver operating curve were used to analyze the predictive value of NPS score, prognostic nutritional index and nutritional prognostic control score on the prognosis of colon cancer patients. Results The NPS score in colorectal cancer was related to tumor stage, distant metastasis, COUNT score and PNI (all P＜0.05). There were 28 deaths in the high NPS group, and the 3-year survival rate was 24.3% (9/37); 13 cases in the low NPS group died, and the 3-year survival rate was 69.8% (30/43). The 3-year survival rate of patients in the high NPS group was significantly lower than that in the low NPS group (χ2=8.124, P＜0.001). Tumor staging, distant metastasis, NPS score, COUNT score and PNI were independent factors affecting the poor prognosis of colon cancer patients. The area under the curve (AUC) of NPS score, PNI and COUNT score were 0.892 (95%CI 0.785～0.998), 0.648 (95%CI 0.473～0.823) and 0.851 (95%CI 0.725～0.978), respectively. Compared with the PNI and COUNT scores, the NPS score has a higher diagnostic value for the death of colorectal cancer patients (Z=11.231, 9.127, all P＜0.001). Conclusion Increased NPS score in colorectal cancer is an independent risk factor for poor survival and prognosis of patients. The predictive power of NPS for the prognosis of colorectal cancer patients is higher than that of the prognostic nutritional index and nutritional prognosis control score, and maybe a new tumor marker for the prognosis of colon cancer