Objective To investigate the prevalence of postoperative thirst in adult patients undergoing general anesthesia, analyze the factors influencing moderate-to-severe postoperative thirst, to develop a nomogram, and to provide a reference for the formulation of graded management strategies for postoperative thirst.Methods This study continuously selected adult patients who underwent elective surgeries under general anesthesia from January to September 2024.A total of 1,326 patients were included in the modeling group, and 232 patients in the validation group.Postoperative thirst-related data were collected using the Riker Sedation-Agitation Scale, the Numeric Rating Scale, and a self-designed clinical data collection form.Important predictive variables were identified using Lasso regression, and a logistic regression prediction model was established along with the nomogram.Results The incidence rate of moderate-to-severe thirst in the modeling group was 53.4% versus 59.9% in the validation group.Lasso regression analysis identified nine influencing factors with non-zero regression coefficients ［surgery duration, age, implementation of Enhanced Reco-very After Surgery （ERAS）, ASA classification, intraoperative fluid volume, intubation method, atropine, esmolol, and intrao-perative blood loss］.A logistic regression prediction model was established based on these nine factors, with AUC values of 0.805 for the modeling group and 0.743 for the validation group.Conclusion The incidence of moderate-to-severe thirst in postoperative adult patients is relatively high.The developed nomogram for predicting moderate-to-severe postoperative thirst provides a reliable assessment tool for healthcare professionals.