Objective To investigate the predictive value of preoperative clinical features for eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP), and to construct a nomogram for clinical practice.Methods A total of 97 patients with chronic rhinosinusitis with nasal polyps (CRSwNP) who underwent functional endoscopic sinus surgery in our hospital from Sept 2019 to Sept 2020 were recruited, and divided into ECRSwNP group and nonesinophilc chronic rhinosinusitis with nasal polyps (nonECRSwNP) group according to the postoperative pathological results of eosinophils (EOS) infiltration. The clinical characteristics of both groups were collected and compared. The univariate and multivariate binary logistic regression analyses were used to screen the preoperative characteristics with predictive value for ECRSwNP, and the nomogram for clinical practice was constructed. SPSS 26.0 and R language software 4.1.2 were used to analyze the data.Results There were significant differences in the history of asthma, peripheral blood EOS percentage (EOS), peripheral blood basophil percentage (Baso), Japanese refractory eosinophilic chronic sinusitis epidemiological survey (JESREC) score, maxillary sinus computed tomography (CT) scores, ethmoid sinus CT scores, total CT scores as well as the ratio of the CT scores for the ethmoid sinus and maxillary sinus (E/M ratio) between the two groups (all P<0.05). The nomogram based on the history of asthma, peripheral blood EOS%, peripheral blood Baso%, maxillary sinus scores, and E/M ratio had a high predictive value for ECRSwNP, and the coordination index value was 0.909 with a 95% confidence interval of 0.828-0.989.Conclusion The nomogram based on asthma history, EOS and Baso in peripheral blood, maxillary sinus CT score and E/M ratio has a high predictive value for ECRSwNP.