A retrospective study identified prognostic factors in critically ill ICU patients with bloodstream infection caused by carbapenem-resistant Acinetobacter baumannii (CRAB-BSI) and developed a risk prediction nomogram. The 30-day mortality rate reached 60.0%. Independent risk factors for mortality were age (OR = 1.04, 95% CI: 1.02–1.07), impaired consciousness (OR = 5.10, 95% CI: 2.27–11.45), previous use of corticosteroids (OR = 5.82, 95% CI: 2.20–15.41), SOFA score (OR = 1.26, 95 % CI: 1.12–1.42) and C-reactive protein (CRP) level (OR = 1.01, 95% CI: 1.01–1.02). The nomogram based on these factors had an area under the curve (AUROC) of 0.863. The calibration curve showed excellent agreement between the predictions and the observed results. Decision curve analysis demonstrated clinical benefit across a wide range of probability thresholds. The nomogram serves as a practical tool for predicting 30-day mortality.