To explore the risk factors of developing MODS and the combined value of predicting MODS in patients with wasp sting. Methods Clinical data of 129 patients with wasps stings admitted to the emergency department, nephrology department and critical care medicine department of the Affiliated Hospital of North Sichuan Medical College from 2014 to 2020 were retrospectively analyzed. Patients were divided into MODS group and non-multiple organ dysfunction syndrome (NMODS) group. The laboratory examination indexes of the two groups were compared, and the difference indexes of the two groups were analyzed by univariate analysis. Multivariate Logistic regression was used to analyze the independent risk factors of MODS in patients with wasps stings, and the predictive value of the independent risk factors was analyzed by receiver operating characteristic curve (ROC curve). Results 129 patients with wasp stings, including 44 cases in the MODS group and 85 cases in the NMODS group, were compared between the two groups of laboratory indicators. The levels of WBC, GR, hsCRP, ALB, ALT, AST, I-Bil, Cystatin C, MPV, APTT and CK-MB in MODS group were significantly higher than those in NMODS group (P<0.05). I-bil (OR=1.196, P<0.001), Cystatin C (OR=7.214, P=0.016) and APTT (OR=1.032, P=0.047) were independent risk factors for MODS in wasp stings. The combined levels of I-Bil, Cystatin C and APTT (hereinafter referred to as I-BIL&Cystatin C&APTT) can predict the MODS of patients with wasps stings. The area under the ROC curve surrounded by the coordinate axes (AUC) was 0.987 (P<0.001), the sensitivity and specificity were 0.93 and 0.986 when the optimal truncation value was 63.31. Conclusion I-Bil, Cystatin C and APTT are risk factors for MODS in wasp sting patients. The combination of I-Bil, Cystatin C and APTT has better predictive value for developing MODS in wasp sting patients.