Objective：This study aims to evaluate the value of combined red blood cell distribution width（RDW）and neutrophil to lymphocyte ratio（NLR），along with model for end-stage liver disease（MELD） scores for predicting prognosis in patients with decompensated cirrhosis. Methods：A retrospective study was conducted on 181 patients with decompensated cirrhosis during January 2013 to December 2016. With death as the end point event，the patients were divided into death group and survival group according to the outcome of 1 year of follow-up. The differences of RDW，NLR and MELD levels at admission between the two groups were compared. Using multivariate Cox risk proportional model to predict independent predictors of the occurrence of 1-year mortality. The receiver operating characteristic（ROC） curve was drawn，and the area under the ROC curve（AUC） was compared. Kaplan-Meier survival analysis was carried out to compare the 1 year survival rate of patients with different RDW and NLR values. Finally，RDW，NLR and MELD scores were combined by binary logistic regression to assess the value of multivariate combination in predicting death within one year. Results：In 181 cases of decompensated cirrhosis，55 died and 126 survived within 1 years of follow-up. The value of NLR，RDW and MELD scores in the death group were statistically higher than those in the survival group（P＜0.05）. Multivariate Cox regression analysis suggested that NLR，RDW and MELD score were independent risk factors for predicting one-year mortality. The optimal cut-off values were 14.65% for RDW，2.58 for NLR，16.65 for MELD，with the AUC were 0.652，0.764 and 0.862，respectively. For combined measurements，the AUC was 0.870 for MELD score plus NLR and 0.876 for MELD score plus RDW，was increased to 0.884 for combination of RWD，NLR and MELD score. Conclusion：The combination of MELD，RDW and NLR has a higher predictive value for the 1-year prognosis of decompensated cirrhosis than MELD alone.