Objective: To explore the predictive value of Nomogram model based on serum markers and British Chest Association modified pneumonia score (CURB-65) for the prognosis of severe pneumonia complicated with acute respiratory distress syndrome (ARDS). Methods: 103 patients with severe pneumonia complicated with ARDS admitted to Ningdu People"s Hospital from January 2022 to October 2024 were divided into survival group (n=42) and death group (n=61) according to their 28-day outcomes. The clinical data, serological indicators [interleukin (IL)-1β, IL-6, IL-8, IL-10, tumor necrosis factor-α (TNF-α)] and CURB-65 scores of the two groups were compared, and the influencing factors of poor prognosis of patients were analyzed by multivariate Logistic regression, and the Nomogram model was constructed and its predictive value was evaluated. Results: The non-survival group had significantly longer mechanical ventilation time and higher levels of IL-1β, IL-6, IL-8, TNF-α, and CURB-65 scores compared to the survival group (P＜0.05), while the level of IL-10 was significantly lower in the non-survival group (P＜0.05). Multivariate logistic regression analysis showed that serum IL-1β, IL-6, IL-8, IL-10, TNF-α, and CURB-65 scores were independent influencing factors for poor prognosis in patients with severe pneumonia and ARDS (P＜0.05). The Nomogram model was constructed according to serum markers and CURB-65 score. ROC curve analysis showed that the area under the curve of the model was 0.936 [95%CI(0.890-0.981)]. Bootstrap method repeated sampling 1000 times, the results showed that the C index was 0.814 [95%CI(0.735~0.856)]; the Hosmer-Lemeshow goodness-of-fit test showed that the model fitted well (χ2=10.142, P=0.073). Conclusion: Serum IL-1β, IL-6, IL-8, IL-10, TNF-α, and CURB-65 scores are predictive factors for poor prognosis in patients with severe pneumonia and ARDS. The Nomogram model constructed based on these markers has good application value for predicting the prognosis of severe pneumonia complicated with ARDS.