BackgroudPerirenal hematoma (PRH) is a notable complication following percutaneous nephrolithotomy (PCNL) with significant implications for patient outcomes. This study aimed to develop a nomogram predictive model for PRH after PCNL.MethodsRetrospective data from patients who underwent PCNL were analyzed. Patient demographics, stone characteristics, and operative details were assessed for their association with PRH using univariate and multivariate analyses. A nomogram was constructed based on identified predictors.ResultsAmong 1047 patients, 6.2% developed PRH. Factors significantly associated with PRH included age, urine culture, stone surface area, operative time and estimate blood loss. These factors were incorporated into the nomogram, providing a user-friendly tool for preoperative risk assessment of PRH following PCNL.ConclusionWe developed a nomogram predictive model for PRH after PCNL, facilitating individualized risk assessment and preventive strategies. Implementation of this nomogram may enhance patient safety and optimize surgical outcomes in PCNL procedures. Further validation studies are warranted to assess its generalizability and accuracy.