Background: Emergence delirium (ED) is a common postoperative complication in pediatric patients, characterized by confusion, agitation, and restlessness. Recent studies suggest that systemic inflammation, particularly the neutrophil-to-lymphocyte ratio (NLR), may play a role in its development. This study aimed to assess the relationship between preoperative peripheral blood parameters, especially NLR, and the incidence of ED in pediatric patients undergoing dental treatment under general anesthesia. Methods: This retrospective, single-center study included 102 pediatric patients (aged 1–7 years) classified as ASA I or II, who underwent dental procedures under general anesthesia at Ankara Medipol University Dental Hospital between January 2023 and July 2024. Preoperative blood tests, including NLR, were collected. ED was evaluated using the Pediatric Anesthesia Emergence Delirium (PAED) Scale. Statistical analyses included Chi-square, Mann-Whitney U tests, multivariate logistic regression, and receiver operating characteristic (ROC) curve analysis. Results: ED occurred in 18 of 102 patients (17.6%). Univariate analysis showed a significantly higher mean NLR in patients with ED (2.0 ± 1.55) compared to those without ED (0.87 ± 0.30)(p < 0.001). However, multivariate logistic regression did not identify NLR or other variables as independent predictors of ED. ROC curve analysis yielded an NLR cut-off of 1.005, with sensitivity 23.1% and specificity 76.3% (Area under the curve (ACU) = 0.234, p < 0.05). Other inflammatory markers, including monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR), also showed significant associations with ED in univariate analyses. Conclusions: Although significant associations between preoperative inflammatory markers and ED were observed in univariate analyses, these markers did not remain independent predictors in multivariate analysis. Nonetheless, the identified correlations highlight the potential role of preoperative inflammatory markers in identifying pediatric patients at increased risk of ED, underscoring the need for further research to establish their clinical utility.