〔Abstract〕 Objective To develop and validate a nomogram based on the albumin-bilirubin（ALBI）score for pre⁃ dicting the risk of severe perioperative complications in patients undergoing hepatectomy for hepatolithiasis. Meth ⁃ ods A retrospective analysis was conducted on the clinical data of 163 hepatolithiasis patients who underwent hepatectomy. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for severe perioperative complications. A nomogram prediction model was constructed and its performance was evaluated. Results Among the 163 patients，66 and 97 were classified into the low-grade and high-grade ALBI groups，respectively. Significant intergroup differences were observed in gender，total bilirubin，albumin levels， and the incidence of severe complications（P<0. 05）. Severe complications occurred in 40 patients. Independent risk factors included age > 60 years（OR=5. 49，P<0. 001），high-grade ALBI（OR=8. 30，P<0. 001），history of biliary surgery（OR=2. 60，P=0. 035），hepatectomy（segmentectomy）≥3（OR=2. 75，P=0. 028），and open surgi⁃ cal approach（OR=4. 00，P=0. 009）. A nomogram for predicting severe perioperative complications was success ⁃ fully established. Internal validation showed that the model had an area under the ROC curve（AUC）of 0. 865， which outperformed traditional single predictors. The calibration curve closely aligned with the ideal curve，with a mean absolute error（MAE）of 0. 027. Decision curve analysis（DCA）demonstrated a net clinical benefit when the threshold probability exceeded 10%，superior to that of traditional predictors. Conclusion The ALBI score-based nomogram is successfully developed and validated to predict the risk of severe perioperative complications in hepa ⁃ tolithiasis patients undergoing hepatectomy. The model demonstrated favorable predictive performance and high clinical utility，serving as an effective tool for both preoperative risk assessment and postoperative risk stratifica ⁃ tion.