Objective To investigate the value of cervical sagittal parameters and the degree of prevertebral soft tissue swelling in predicting dysphagia following Anterior Cervical Spine Surgery （ACSS）. Methods Clinical data of 262 patients with cervical spondylosis who were scheduled to undergo ACSS at the hospital from January 2021 to December 2023 were retrospectively collected. All patients were closely monitored for 48 hours post-operatively and then assigned to either a dysphagia group （n = 127） or a non-dysphagia group （n = 135） based on the development of dysphagia within 48 hours. The clinical data， cervical sagittal parameters， and the degree of prevertebral soft tissue swelling were compared between the two groups. Multivariable logistic regression analysis was employed to identify the factors associated with dysphagia after ACSS. Receiver Operating Characteristic （ROC） curves were plotted to assess the predictive value of each factor for post-ACSS dysphagia， and a nomogram model was constructed. Results Multivariable logistic regression analysis demonstrated that TIS， TIA， and NT were independent protective factors against dysphagia following ACSS. In contrast， C2-7 SVA and the degree of prevertebral soft tissue swelling were identified as independent risk factors （P < 0.05）. The combined prediction utilizing TIS， C2-7 SVA， TIA， NT， and the degree of prevertebral soft tissue swelling exhibited a higher predictive value compared to any individual parameter （Z_TIS-combined = 5.848， Z_{C2-7 SVA-combined} = 5.384， Z_TIA-combined = 6.708， Z_NT-combined = 5.848， Z_{degree of prevertebral soft tissue swelling-combined} = 6.643， P < 0.05）. The nomogram indicated that the predictive performance of the model was in line with the observed outcomes. The area under the ROC curve （AUC） was 0.84 （0.75 - 0.92） for the training set and 0.83 （0.74 - 0.92） for the validation set， suggesting good predictive performance. Moreover， the model showed a high net benefit across probability thresholds ranging from 50% to 90%. Conclusion Cervical sagittal parameters， when combined with the degree of prevertebral soft tissue swelling， demonstrated good predictive performance for postoperative dysphagia after ACSS and may offer a theoretical basis for the clinical screening of high-risk individuals.