OBJECTIVE: This study aims to evaluate the clinical utility and effectiveness of a nomogram model in predicting outcomes for patients with benign esophagogastric anastomotic stenosis (BES) undergoing fluoroscopic balloon dilation (FBD). METHODS: The clinical data of 428 patients with BES who received FBD treatment at our hospital between January 2013 and June 2023 were retrospectively analyzed. The patients were divided into training and validation cohorts in a 7:3 ratio. Relevant risk factors influencing patient prognosis were identified, and a nomogram model was developed to predict stenosis-free survival rates at 3, 6, 12, and 24 months. The model's accuracy was assessed by calculating the area under the receiver operating characteristic curve (AUC), and its predictive performance was validated in the test group. RESULTS: The baseline data comparison between the training and validation groups revealed no significant differences, ensuring the comparability of the groups. Cox regression analysis identified that age, history of fistula or not, stenosis severity, and balloon diameter were independent risk factors influencing stenosis-free survival in patients with BES. The area under AUC for the nomogram prediction model of stenosis-free survival at 3, 6, 12, and 24 months was 0.77, 0.81, 0.85, and 0.83, respectively, in the training group, and 0.74, 0.80, 0.84, and 0.83, respectively, in the validation group. CONCLUSIONS: Age, history of fistula, stenosis severity, and balloon diameter were identified as independent risk factors influencing the prognosis of BES. The nomogram model developed in this study demonstrates strong discriminatory power and holds significant clinical value for prognostic assessment.