Background and purpose There are recognized surgical indications for Bernese periacetabular osteotomy (PAO), but the degree of postoperative functional recovery is significantly different through clinical observation and follow-up. Therefore, it is necessary to do a preoperative evaluation. This study aims to screen the factors influencing functional recovery after PAO and construct a predictive nomogram.Patients and methods: Retrospective data were collected between December 2016 and March 2022 at The First Affiliated Hospital of Shandong First Medical University, including demographic data and imaging materials of patients undergoing PAO. The least absolute shrinkage and selection operator regression was used to screen the influencing factors, and then multivariate logistic regression analysis was employed to construct a predictive nomogram for predicting functional recovery after PAO.Result The influencing factors of functional recovery after PAO were screened out, namely the preoperative distance from the innermost surface of the femoral head to the ilioischial line, surgical approach, preoperative acetabular depth, and preoperative Calve line continuity. A nomogram model was established using these significant predictors. The receiver-operating characteristic curve was drawn, and the area under the curve was calculated to be 0.864. The calibration curve showed that the constructed nomogram model was well calibrated. There was sufficient consistency between the observed and estimated prediction probabilities to indicate that the clinical prediction model had high accuracy.Conclusion This predictive nomogram can identify the patients most suitable for PAO and can be used to guide the selection of surgical patients and surgical approaches.