To investigate the prognostic value of the presepsin:albumin ratio and C‑reactive protein:albumin ratio in patients with sepsis in the intensive care unit (ICU).A total of 228 (129 males and 99 females) patients with newly diagnosed sepsis were included in the study. The relationship between the C‑reactive protein:albumin ratio, presepsin:albumin ratio, clinicopathologic parameters, and overall survival were investigated. The associations between C‑reactive protein:albumin ratio and presepsin:albumin ratio were evaluated alongside other inflammation-based prognostic scores such as quick Sepsis Related Organ Failure Assessment (qSOFA).The presepsin:albumin ratio was significantly higher in non-survivors (p < 0.01). Patients with a high presepsin:albumin ratio had worse overall survival compared with patients with high C‑reactive protein:albumin ratio levels (p < 0.001).Presepsin and presepsin:albumin ratio are markers of adverse prognosis in patients with sepsis and are superior to C‑reactive protein and C‑reactive protein:albumin ratio for this purpose. Presepsin:albumin ratio may be a novel marker of poor prognosis in patients with sepsis in intensive care units.