Objective To explore the prognostic value of serum procalcitonin/albumin ratio (PCT/ALB) combined with sequential organ failure assessment (SOFA) in septic patients. Methods A retrospective analysis was made of 75 patients with sepsis, who were treated in the Emergency Department of Bethun Hospital Affiliated to Shanxi Medical University from January 2019 to January 2020. The patients were divided into survival group (n=65) and death group (n=10) according to 28d outcomes. On admission, the patients were monitored for clinical indicators, PCT/ALB ratios and SOFA were calculated. SPSS statistics 26.0 was used for data analysis. t-test and χ² were used for comparison. Cox regression was used to analyze the independent risk factors of sepsis, and receiver operating characteristic (ROC) curve was made to do the predictive analysis of risk factors in patients with sepsis. Results PCT, PCT/ALB, SOFA were higher in the survival group than in the death group, and ALB was lower in the death group than in the survival group, the difference being statistically significant (P<0.05 for both). PCT/ALB (HR＝4.527, 95%CI 1.321-15.512 ), SOFA (HR＝1.287, 95%CI 1.081-1.534) were independent risk factors for 28 d mortality risk. PCT/ALB combined SOFA was superior to other indicators in predicting patients with sepsis at 28 days, with an AUC of 0.825, the best cut-off point of 1.824, a sensitivity of 80.0% and a specificity of 81.5%. Conclusion PCT, ALB, PCT/ALB, SOFA are helpful for the assessment of septic patients condition. PCT/ALB and SOFA are independent risk factors for 28 d mortality. PCT/ALB combined with SOFA is superior to single indicator for prognosis of septic patients.