We assessed the usefulness of PNI (PNI = 10 x serum albumin + 0.005 x peripheral lymphocytes) as a prognostic indicator and determinant of multimodal treatment for 30 gynecological patients (control group: 12 patients with gynecological benign disease; good prognostic group: 10 with more than two-year survival having gynecological cancer; poor prognostic group: 8 with less than one-year survival having gynecological cancer). It was concluded that 1) PNI of the poor prognostic group was significantly lower than that of good prognostic group and control group (p < 0.01); 2) PNI is effective as a prognostic indicator; and 3) PNI is useful in clinical practice as a determinant of the multimodal treatment and high risk group.