Objective To investigate the velum (palatopharyngeal), oropharygneal, tongue base, and epiglottis (VOTE) scores and the influencing factors in drug-induced sleep endoscopy (DISE) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Ninety-five OSAHS patients undergoing DISE in our hospital from March 2019 to March 2021 were selected, their VOTE scores of DISE were assessed by 2 physicians with similar experience, and the intra-group correlation coefficient (ICC) was used to evaluate the consistency of the total VOTE scores of OSAHS patients assessed by the 2 physicians. The VOTE scores of patients with different clinical profiles were also compared, and the influencing factors were analyzed by multiple linear stepwise regression model.Results The average total VOTE score of the 4 obstruction planes in the 95 patients was (4.07±0.81). Of them, the palatopharyngeal score (1.49±0.13) was dominated by circumferential obstruction, the oropharyngeal score (1.38±0.15) by left-right obstruction, the tongue base score (1.05±0.10) by anterior-posterior obstruction and the epiglottis score (0.15±0.02) by left-right. The ICC values for the two physicians assessing the palatopharyngeal, oropharyngeal, tongue base, and epiglottis scores were 0.912 (95%CI：0.846-0.972), 0.926 (95%CI：0.871-0.984), 0.975 (95%CI：0.891-0.990), and 0.989 (95%CI：0.912-0.998) respectively (P<0.05). The differences of total VOTE scores of patients with different body mass index (BMI), anesthesia induction method, Fridman staging, disease severity, and lowest oxygen saturation were statistically significant (P<0.05). The multiple linear stepwise regression analysis showed that the BMI, anesthesia induction method, Fridman typing, disease severity, and lowest oxygen saturation were all factors influencing the total VOTE scores (P<0.05).Conclusion In the assessment of OSAHS with DISE, higher scores are obtained in the palatopharyngeal, oropharyngeal, and tongue base planes in the VOTE scoring system, and the factors influencing the total VOTE score include BMI, anesthesia induction method, Fridman staging, disease severity, and lowest oxygen saturation.