Objective To analyze the risk factors of postoperative delirium (PD) in patients undergoing carotid artery stenting (CAS) and to provide reference for targeted intervention. Methods The prevalence of PD in 350 patients undergoing CAS was calculated.Risk factors of PD were determined by using t-test,Mann-Whitney U-test,Chi-square test and multivariate logistic regression, then a nomogram was developed based on the regression-based coefficients. The calibration curve and ROC curve were performed to evaluate the accuracy and discrimination of the nomogram model. Results Sixty patients developed PD, with the prevalence of 17.14%. Multivariate logistic regression revealed that advanced age, preoperative National Institutes of Health Stroke Scale score and preoperative Self-rating Anxiety Scale score were risk factors for PD (P<0.05 for all). A nomogram based on these variables was established, and the calibration curves for the probability of PD showed optimal agreement between the probability as predicted by the nomogram and the actual probability. The model showed a robust discrimination, with an area under the ROC curve of 0.888. Conclusion The prevalence of PD is relatively high in patients undergoing CAS. Advanced age, preoperative anxiety and stroke tendency are risk factors for PD. The nomogram model has good accuracy and discrimination, and could improve the screening efficiency.