Objective: To investigate the value of preoperative and postoperative changes in lactate dehydrogenase to albumin ratio (LDH/albumin ratio, LAR) in assessing the prognosis of colon cancer. Methods: The clinical data of 134 colon cancer patients who underwent gastroenterology surgery at Jiangnan University Hospital from June 2012 to December 2015 were randomly selected. Patients’ clinical pathological characteristics were collected, including gender, age, TNM staging, etc. to calculate the LAR values before and within one week after surgery and to determine the optimal cut-offvalue by using the receiver operating characteristic curve(ROC). Kaplan-meier method of survival analysis was used to draw the survival curve, log-rank test to perform univariate analysis and Cox multivariate regression analysis to conduct multivariate analysis. Results: Median follow-up time was 72 months (2-102 months). According to the optimal cut-off values of preoperative and postoperative LAR, 134 patients were divided into preoperative high-LAR group, preoperative low-LAR group, postoperative high-LAR group and postoperative low-LAR group. The 5-year OS (overall survival) rate was 43% in the preoperative high-LAR group and 85% in the preoperative low-LAR group, and the 5-year PFS rate was respectively 45% and 83%; while the 5-year OS rate was 62% in the postoperative high-LAR group and 82% in the postoperative low LAR group, and the 5-year PFS rate was respectively 70% and 77%. Based on the joint analysis of preoperative and postoperative LAR, 134 patients were further divided into 3 groups: LAR1 group (both preoperative and postoperative high LAR), LAR2 group (either preoperative or postoperative high LAR), and LAR3 group (both preoperative and postoperative low LAR). Univariate and multivariate analysis suggested that the 5-year OS rate of LAR1 group, LAR2 group and LAR3 group was 33%, 78% and 85% respectively with statistically significant differences (P<0.01). Lymph node metastasis was significantly correlated with patients’ OS and PFS (P<0.01) and clinical staging with PFS (P<0.01). Conclusion: Joint detection of dynamic changes of preoperative and postoperative LAR can help determine the prognosis of colon cancer and guide further individualized treatment. Preoperative and postoperative high LAR is an independent factor of poor prognosis for OS in colon cancer patients.