ABSTRACT Aims The objective of this study was to investigate the risk factors for post‐operative hypothermia in adult patients and to develop a prediction model. Background Post‐operative hypothermia is one of the most common complications and thus increases the degree of clinical and nursing risk. The previous studies mainly focused on intraoperative or post‐operative hypothermia with limited data. Design Cohort study. Methods A total of 99,644 records including anaesthesia and post‐anesthesia care files were retrieved from October 1, 2021 to February 10, 2023, including 89,663 files in the training group and 9981 files in the validation group. The primary outcome was the incidence of post‐operative hypothermia in the post‐anesthesia care unit. Multivariate logistic regression was used to identify risk factors for post‐operative hypothermia. A logistic regression nomogram was subsequently created to predict the probability of post‐operative hypothermia during the post‐anesthesia care unit stay. Results The independent risk factors for post‐operative hypothermia included male sex, age, low body mass index, anaesthesia duration, chest surgery and urological surgery. A nomogram was established to predict the probability of post‐operative hypothermia during the post‐anesthesia care unit stay. In the model, the areas under the receiver operating characteristic curve values in the training and validation groups were 0.86 and 0.87, respectively. The Brier scores in the training and validation groups were 3.46% and 3.34%, respectively. Conclusions In this study, the incidence of post‐operative hypothermia was 3.6%. The following variables are independently associated with post‐operative hypothermia: age, male sex, BMI, duration of anaesthesia, surgical type and anaesthesia type. A novel prediction model is feasible for predicting the probability of post‐operative hypothermia during the post‐anaesthesia care unit stay. Reporting Method TRIPOD + AI checklist. Relevance to Clinical Practice Nurses can utilise the predictive model to assess the risk of post‐operative hypothermia, offering valuable guidance for implementing preventive measures. Patient or Public Contribution No patient or public contribution.