Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 0 0 2026 07 22 1 10 Alireza Sharifi 1 Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran Maryam Sharifi Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Elham Farasat Pediatric Clinical Research Development Unit, Hazrat Masoumeh Hospital, Qom University of Medical Sciences, Qom, Iran Maryam Yaghoubi Hamgini ENT and Head and Neck Research Center and Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Shohreh Norouzi Department of Otolaryngology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Selda Zahedi Abdi Department of Anesthesiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Parsa Taghavi Student Research Committee, School of Dentistry, Islamic Azad University, Tehran, Iran Nadereh Alani Department of Otolaryngology, School of Medicine, Qom University of Medical Sciences, Qom, Iran Shahram Seyedi Department of Microbiology and Immunology, School of Medicine, Islamic Azad University, Tehran, Iran Mehran Jamali Department of Oral and Maxillofacial Surgery, School of Dentistry, Qom University of Medical Sciences, Qom, Iran Mohammad Ghaffari Department of Epidemiology and Biostatistics, Faculty of Health, Qom University of Medical Sciences, Qom, Iran Samad Samadizadeh Department of Oral and Maxillofacial Surgery, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran Brent Senior Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA Joseph Lebowitz Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA 2026 04 14 2026 06 06 A growing number of literatures explores the diagnostic role of serum eosinophil-to-lymphocyte ratio (ELR) and platelet-to-lymphocyte ratio (PLR) in patients with allergic rhinitis (AR), yielding variable findings and lacking control of potential confounding variables and standardized cut-offs for clinical application. We aim to clarify their role through a systematic review and meta-analysis. Web of Science, PubMed, Embase, Scopus, Cochrane Central Register of Control Trials, Google Scholar, and Medline were systematically searched up to October, 2025. The search strategy was described by a combination of relevant medical subheadings (MeSH) and keywords. Eligible English language studies were reviewed, and their quality was appraised. This review adhered to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A total of 12 studies, including 3 449 individuals, met the inclusion criteria. AR group had significantly higher ELR (SMD: 0.64) and insignificantly lower PLR (SMD−0.02) than control. Patients with persistent AR had, numerically but not significantly, higher ELR (SMD: 1.19) and PLR (SMD: 0.58) compared to intermittent AR. ELR value of greater than 0.085 had a pooled AUC of 67% in discrimination of patients with AR from control. This AUC rate was statistically significant. This review investigated that no clear correlation was found between mean PLR and AR. However, mean ELR was found to be significantly increased in patients with a diagnosis of AR, and a numerical trend toward higher ELR with greater disease severity was observed. Though further research is necessary to determine its clinical utility. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/4797 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/4797/2375