Objective To explore the risk factors of ptosis in patients with cataract (CAT) after phacoemulsification (PHACO) combined with intraocular lens implantation (ILI) surgery. Methods Monocular CAT patients (216 cases, 216 eyes) who underwent PHACO and ILI in our hospital from June 2018 to November 2021 were selected as the research subjects. The clinical efficacy of the surgery was analyzed. According to the occurrence of ptosis after surgery, they were divided into a ptosis group (54 cases) and a non-ptosis group (162 cases). The clinical data and surgery-related indicators of the two groups were compared and analyzed. Multivariate Logistic regression analysis was performed to analyze the risk factors for postoperative ptosis, and a risk scoring model was established to evaluate the model. Results Compared with before operation, the best corrected visual acuity, intraocular pressure, anterior chamber depth and anterior chamber angle opening of CAT patients after PHACO combined with ILI surgery were significantly improved (P<0.05). The results of multivariate Logistic regression analysis showed that age(70 years old, peribulbar anesthesia, 7-gauge anesthesia injection needle, adrenalin mixed in anesthesia, the use of superior rectus traction line during operation, and the use of eyelid opener during operation were all independent risk factors for postoperative ptosis (P<0.05). Scores are weighted according to the regression coefficient β, and X-tile software is used to obtain the score cutoff value, and the risk scoring model divides patients with postoperative ptosis into three groups: low-risk (≤81 points), intermediate-risk (>81 points and (112 points) and high-risk groups (>112 points). The model evaluation results show that the risk scoring model has good discrimination, accuracy and validity, and is safe, reliable and practical.Conclusion PHACO combined with ILI surgery can effectively improve the condition of CAT patients. Age(70 years old）, peribulbar anesthesia, 7-gauge anesthesia injection needle, epinephrine mixed in anesthesia, intraoperative use of superior rectus traction line, and intraoperative use of eyelid opener are all independent risk factors for postoperative ptosis