Objective: To analyze the risk factors of hospital-acquired pneumonia (HAP) among elderly stroke patients, to and establish and validate the nomogram model for prediction of the risk of HAP. Methods: Independent risk factors of HAP were investigated based on the clinical data of 120 elderly stroke patients admitted to Beijing Friendship Hospital, Capital Medical University in 2020 by a case-control study. On the heels of risk analysis, a nomogram model predicting individual risk of HAP was constructed and verified. Results: HAP occurred in 26 of 120 patients, with an incidence of 21.67%. The risk factor analysis showed that diabetes, chronic obstructive pulmonary disease (COPD), dysphagia, disturbance of consciousness, indwelling gastric tube, tracheal incision, and lasting mechanical ventilation were the most common independent risk factors of HAP. The receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of the HAP risk prediction model is 0.897 (95%CI 0.815 to 0.980). The slope of the calibration curve was close to 1 and the Hosmer-Lemeshow goodness-of-fit was good (χ²=9.748, P=0.283). Conclusion: The nomogram model has good discrimination and accuracy, which can accurately predict the individual risk of HAP among elderly stroke patients and provide a basis for the prevention and control of hospital infections.