A retrospective study analyzed 256 patients with intrauterine adhesions (IUA) after hysteroscopic adhesiolysis in 2018–2020 as a model group and 128 patients in 2020–2021 as a validation group. The recurrence rate in the model group was 20.31%. Multivariate logistic regression identified as independent risk factors: disease duration >12 months and 12 days, number of artificial abortions >2, number of previous operations in the uterine cavity >1 and extent of adhesion ≥1/2 of the uterine cavity (p < 0.05). Based on these factors, a nomogram model was created to predict recurrence. Internal validation showed an area under the ROC curve of 0.767 and good calibration (Hosmer–Lemeshow test: χ²=6.427, p=0.316). External validation confirmed AUC 0.779 and calibration (χ²=7.006, p=0.352). The nomogram demonstrated high clinical utility with a threshold probability of 0.02–0.89 in the model group and 0.02–0.92 in the validation group. The model provides doctors with a simple tool for individualized prediction of the risk of recurrence.