Abstract: ob＜x＞jective In order to analyze and predict the long-term remission of patients with pituitary growth hormone adenoma after endoscopic transsphenoidal surgery, explore the factors affecting the postoperative remission, and establish nomogram prediction model ba＜x＞sed on these factors. Methods The clinical data of 96 patients with pituitary growth hormone adenoma treated by endoscopic sinus surgery from January 2015 to June 2020 were collected. The best predictors were screened by lasso regression analysis, and the risk predictors were further screened by multivariate logistic regression analysis. Nomogram prediction model is constructed according to risk prediction factors. The area under the receiver operating curve (ROC) was used to evaluate the discrimination performance of the model, the bootstrap method was used to verify the model, and the consistency index (c-index) was calculated to evaluate the discrimination of the model; The calibration curve is drawn to evaluate the calibration degree of the model. Finally, the decision curve analysis is used to evaluate the best prediction range of the model. Results A total of 96 consecutive patients with pituitary growth hormone adenoma were included. In the final follow-up, 61 (63.5%) met the remission standard and 35 (36.5%) did not. Preoperative GH or = 1.262,95% CI (1.068, 1.491), P = 0.006, knosp3-4 or = 8.79,95% CI (2.025, 37.467), P = 0.004, preoperative IGF-1 or = 1.009,95% CI (1.002, 1.015), P = 0.008, maximum diameter of adenoma (MPAD) or = 1.124,95% CI (1.014, 1.245), P = 0.026 were independent predictors of unresponsive postoperative vertical growth hormone adenoma. The nomogram prediction model predicted that the area under the ROC curve of unresponsive patients with pituitary growth hormone adenoma was 0.897 95% CI (0.828, 0.967); Through internal verification, the c-index of the model is 0.925; The calibration curve shows that the model results are in good agreement with the actual results. At the same time, DCA curve shows that the model is useful in clinical work. Conclusion In this study, ba＜x＞sed on these important predictors, we constructed nomogram prediction of non- remission in patients with pituitary growth hormone adenoma. The model is helpful for clinicians to predict postoperative remission, guide patients’ follow-up plan, and formulate corresponding accurate treatment plan.