Objective <p>This study aimed to develop and validate a nomogram model for predicting cerebral infarction risk after superficial temporal artery–middle cerebral artery (STA-MCA) bypass in patients with intracranial atherosclerotic stenosis (ICAS).</p> Methods <p>Patients with ICAS who received STA-MCA bypass were enrolled in this study. The independent risk factors for post bypass infarction were identified using univariate and multivariate logistic regression analyses. A nomogram model was developed and subsequently evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).</p> Results <p>Eventually, 316 patients with ICAS were included in the study. Diabetes, smoking, and high triglyceride and total cholesterol levels were identified as the independent risk factors, and a nomogram model was developed. The model achieved areas under the curve (AUCs) of 0.88 (95% confidence interval [CI] = 0.79–0.97) in the training cohort and 0.84 (95% CI = 0.72–0.97) in the validation cohort. Moreover, the calibration curves matched well, and the DCA indicated favorable clinical utility of the model.</p> Conclusions <p>We develop a nomogram model for infarction after STA-MCA bypass in patients with ICAS, which could assess the risk of infarction quickly. The model could significantly guide clinical decisions and reduce the incidence of infarction.</p> Clinical trial number <p>Not applicable.</p>