Background/aim <p>The prognostic outcome of the Naples prognostic score (NPS) in patients with colorectal liver metastases (CRLMs) who have undergone hepatectomy has not been investigated. The present study investigated the prognostic value of the preoperative NPS score and other systemic inflammation-related biomarkers in patients who underwent hepatectomy for CRLMs.</p> Patients and methods <p>The subjects included 179 patients with CRLMs who underwent hepatectomy and retrospectively investigated the association of preoperative NPS with the surgical failure-free survival (SFFS), disease-free survival (DFS), and overall survival (OS) using univariate and multivariate analyses.</p> Results <p>In this study, the cutoff NPS value was 2. In the univariate analysis, a high NPS was associated with a worse SFFS (<i>p</i> = 0.04) and OS (<i>p</i> = 0.02). The multivariate analysis showed significant and independent predictors of the OS were extrahepatic lesions (<i>p</i> &lt; 0.01), serum carcinoembryonic antigen (CEA) levels (<i>p</i> = 0.04), and a high NPS (<i>p</i> = 0.04).</p> Conclusion <p>The NPS can be useful in predicting long-term outcomes in patients with CRLMs after hepatectomy.</p>