Objective: To explore the influencing factors of acute moderate to severe pain in children with traumatic limb fracture,and to develop a nomogram prediction model to predict pain risk within 24 hours in these children. Methods: From June 2024 to December 2024, 300 children and their parent with limb fracture undergoing surgery were included in the study . The independent risk factors of APSP through univariate analysis and Logistic regression analysis were explored. According to these selected independent risk factors, a risk prediction model was established and incorporated into the nomogram, and the model power and its accuracy were evaluated by receiver operating characteristic(ROC). Results: The risk prediction model was constructed based on 3 influencing factors, including degree of limb swelling, preoperative pain and preoperative anxiety of children. The area under the predicted ROC curve was 0.906. When the Yoden index was 0.617 , the optimal critical value was 0.779, the sensitivity was 0.695, and the specificity was 0.922. The Hosmer-Lemeshow test wast =0.525(P=0.971). Conclusion: The prediction model constructed in this study has a good effect, which can provide a reference for clinical evaluation of the risk of APSP in children with limb fracture.