Abstract: Objective To identify potential risk factors for adult fulminant myocarditis（FM） and establish a early risk assessment model based on significant factors. Methods Retrospective analysis of 268 patients with myocarditis admitted to the first affiliated hospital of Fujian Medical University from 2013-2021 and the Fujian Medical University Union Hospital from 2017-2021. Risk factors for FM identified by multivariate logistic regression analysis were used to create a Nomogram. Receiver operating characteristic curve（ROC）was used to evaluate the differentiation of Nomogram, and decision curve analysis（DCA） was used to evaluate the clinical usefulness. Results Of the 268 patients with myocarditis, 215 patients were diagnosed with non-fulminant myocarditis（NFM）, and 53 with FM. Stepwise regression analysis showed that age（OR=1.869,95%CI 1.119-3.120,P=0.017）, conduction block or bradycardia（OR=38.700,95%CI 4.191-357.343,P=0.001）, hydropericardium（trace: OR=29.093, 95%CI 0.393-2 155.855,P=0.125; small: OR=12.449, 95%CI 1.360-113.976, P=0.026; medium: OR=34.610, 95%CI 1.185-1 010.446, P=0.040）, N-terminal pro-B-type natriuretic peptide（NT-proBNP）（OR=1.013, 95%CI 1.000-1.025, P=0.042）, cardiac troponin I（cTnI）（OR=1.170, 95%CI 1.008-1.358, P=0.038）, blood glucose（OR=1.439, 95%CI 1.179-1.757, P＜0.001）, blood calcium（OR=0.529, 95%CI 0.421-0.665, P=0.017） and left ventricular ejection fraction（LVEF）（OR=0.484, 95%CI 0.264-0.886, P=0.019） were independent influencing factors for FM. The Nomogram model based on the eight influencing factors had good prediction effect. The area under the ROC curve（AUC） was 0.95（95%CI 0.94-0.98）. Conclusion Age, conduction block or bradycardia, hydropericardium, NT-proBNP, cTnI, blood glucose, blood calcium, and LVEF were independent risk factors for FM, and the Nomogram model constructed on the basis of risk factors had a high predictive value for FM.