Objective To investigate the risk factors of hypotension duration intraspinal anesthesia for cesarean section, and establish a nomogram model of hypotension for cesarean section under intraspinal anesthesia. Methods A total of 240 parturients who were admitted to Maanshan 17th Metallurgical Hospital for cesarean section under intraspinal anesthesia from April 2019 to July 2022 were selected as a model group. Meanwhile, 44 women who underwent intraspinal anesthesia for cesarean section from October 2022 to June 2023 were selected as a verification group. Univariate and multivariate logistic regression analyses were used to screen the risk factors of hypotension caused by cesarean section under intraspinal anesthesia. R software was used to establish a nomogram model of hypotension due to intraspinal anesthesia for cesarean section, and the nomogram model was verified. Results Among 240 parturients who underwent intraspinal anesthesia for cesarean section, there were 110 cases of hypotension, with an incidence of 45.83% (110/240). Logistic regression analysis showed that body mass index (BMI)≥28 kg/m2, preeclampsia, diabetes, preoperative heart rate≥90 times/min and uterine height>36 cm were the risk factors for hypotension due to intraspinal anesthesia for cesarean section (all P<0.05). The consistency index (C‑index) was 0.719 [(95% confidence interval (CI) 0.683, 0.756), P<0.05] for the model group, and 0.731 [95%CI (0.699, 0.764), P<0.05] for the verification group. The calibration curves of both the model group and the verification group showed a good fit between the predicted value and the actual value. The area under receiver operator characteristic (ROC) curve of the model was 0.708 [95%CI (0.675, 0.741), P<0.05], with a sensitivity of 72.93% and a specificity of 80.90%; the negative predictive value was 80.00%, and the positive predictive value was 71.43%. In contrast, the area under ROC curve of the verification group was 0.720 [95%CI (0.687, 0.753), P<0.05], with a sensitivity of 75.41%, and a specificity of 82.36%; the negative predictive value was 83.14%, and the positive predictive value was 73.82%. When the decision curve of the model group showed the threshold probability at 24%‒84%, the net benefit value of the column graph predicting hypotension due to intraspinal anesthesia for cesarean section was higher. When the decision curve of the verification group showed the threshold probability at 23%‒100%, the net benefit value of the column graph predicting hypotension due to intraspinal anesthesia for cesarean section was higher. Conclusions BMI≥28 kg/m2, preeclampsia, diabetes mellitus, preoperative heart rate≥90 times/min and uterine height>36 cm are the risk factors due to hypotension induced by intraspinal anesthesia for cesarean section. The accuracy and clinical application value of the nomogram model for intraspinal anesthesia induced hypotension during cesarean section are common.