Objective To explore the ultrasound image features of chest wall recurrent nodules after modified radical mastectomy and to establish a prediction model. Methods Ultrasound image features of chest wall nodules of 102 patients(57 patients with recurrent nodules and 45 patients with benign nodules) after mastectomy were retrospectively analyzed. The ultrasound features were screened using regression analysis, and then the screened features were used to build a regression model. Results Chest wall recurrent nodules after mastectomy often show single or multiple hypoechoic solid masses with multilayer tissue structure implication, poorly defined borders, irregular morphology, and low to medium blood flow signals. Multifactorial analysis showed that maximum diameter, number, borders, blood flow signal and postoperative intervals were independent predictors of the risk of malignant nodules（P<0.05）. The logistic regression model showed that the risk sensitivity, specificity and accuracy was 91.2%, 82.2% and 87.3%, with the area under curve 0.935. Conclusions Prediction model based on ultrasound features can effectively evaluate the malignant risk of chest wall nodules after modified radical mastectomy.