Objective To construct a Nomogram risk prediction model for early recurrence of hepatocellular carcinoma （HCC） radical hepatectomy based on CT imaging omics and traditional Chinese medicine tongue imaging features. Methods 216 patients who underwent HCC radical hepatectomy in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from September 2018 to September 2022 were selected，the clinical dataes were retrospective analyzed.The patients were randomly divided into modeling set （n = 152） and validation set （n = 64） by 7：3 ratio，the recurrence situation one year after surgery of the two groups were recorded.A recurrence prediction model was constructed by the modeling set of patient dataes， all patients underwent postoperative plain scan combined with enhanced CT examination， and the Imaging omics feature indicators was extracted， the tongue imaging characteristics was recorded，the Cox multivariate model was used to analyze the factors related to postoperative recurrence in the modeling set of patients， and a risk prediction model was constructed，the model was validated by validation set dataes. Results There were 52 patients in the modeling set experienced recurrence within 1 year， the recurrence rate was 34.21%；there were 23 cases of recurrence in the validation set patients within 1 year， the recurrence rate was 35.94%.The Cox multivariate model analysis showed that the Rad-score， Tongue texture and tongue shape were independent influence factors for postoperative recurrence of HCC （P < 0.05）. Based on this， the Nomogram column chart was established.The ROC analysis showed that the AUC of the column chart model for predicting postoperative recurrence in the modeling set and validation set patients were 0.811 and 0.824， the sensitivities were 0.875 and 0.833 respectively， the specificities were 0.617 and 0.750 respectively. Conclusions The early postoperative recurrence of HCC is related to Rad score， tongue texture， and tongue shape. Based on this， the Nomogram prediction model constructed has high accuracy in predicting early postoperative recurrence.