Background <p>The prognostic value of the Platelet-to-High-Density Lipoprotein Ratio (PHR) in HCC patients who underwent hepatectomy remains unclear. This study aims to explore the clinical association between PHR and HCC, as well as the prognostic value of PHR in HCC patients after hepatectomy.</p> Materials and methods <p>This retrospective cohort study included 446 HCC patients who underwent curative-intent hepatectomy. The association between PHR and overall survival (OS) was analyzed using Kaplan-Meier and Cox regression methods. A prognostic nomogram incorporating PHR was developed and validated internally.</p> Results <p>Different levels of PHR show a significant correlation with the clinicopathological characteristics of HCC. Preoperative low PHR is associated with better overall survival (OS) (Hazard Ratio [HR]: 0.63, 95% CI: 0.43–0.91, P = 0.013) in post-hepatectomy HCC patients, and the nomogram incorporating PHR demonstrates a modest net benefit in predicting OS.</p> Conclusion <p>The PHR could independently predict HCC OS after hepatectomy. The nomogram incorporating the PHR may aid in the prognostic management of HCC.</p>