ABSTRACT Clinical relevance Systemic inflammation factors (e.g. white blood cells and neutrophils), high level of triglyceride and high neutrophil-to-lymphocyte ratio have significant associations with the risk of polypoidal choroidal vasculopathy (PCV). Background This study aimed to investigate associations of complete blood cell count-derived indicators and serum lipid levels with PCV. Methods Forty-eight patients with PCV and 54 age- and gender-matched control group participants were included in the study. Records of demographic characteristics and the results of ophthalmic examinations and haematologic parameters for the participants were collected retrospectively. Blood cell count-derived indicators and serum lipid levels were calculated and were compared between the two groups. Results The PCV group had higher white blood cell, neutrophils, triglyceride, and neutrophil-to-lymphocyte ratio levels and lower mean corpuscular volume level, compared with the control group (P = 0.002, P < 0.001, P = 0.003, P = 0.002, and P = 0.027, respectively). White blood cell, neutrophil, triglyceride, and neutrophil-to-lymphocyte ratio were independent risk factors for PCV (odds ratio [OR] = 1.668, 2.324, 2.846, and 2.543, respectively; P = 0.003, P = 0.001, P = 0.005, and P = 0.004, respectively). Mean corpuscular volume was an independent protective factor against PCV (OR = 0.902; P = 0.031). Receiver operating characteristic curve analysis revealed that the area under the curve values for white blood cell, neutrophil, triglyceride, neutrophil-to-lymphocyte ratio, and mean corpuscular volume was 0.656, 0.687, 0.660, 0.659, and 0.633, respectively (P< 0.05, respectively). The combined area under the curve value was 0.772 (P < 0.001). Conclusions White blood cells, neutrophils, triglycerides, and the neutrophil-to-lymphocyte ratio were the risk factors for PCV. Mean corpuscular volume was a protective factor against PCV. These results suggested that the combination of white blood cells, neutrophils, triglyceride, neutrophil-to-lymphocyte ratio, and mean corpuscular volume can be used to predict PCV.