Objective: To investigate the risk factors of triple negative breast cancer (TNBC) complicated with axillary lymph node metastasis, and predict the parameters of contrast-enhanced ultrasound (CEUS) to construct a neographic model of TNBC complicated with axillary lymph node metastasis. Methods: The clinical data of 165 patients with TNBC treated in our hospital from January 2020 to June 2022 were retrospectively analyzed, and the patients were divided into metastatic group and non-metastatic group according to the occurrence of axillary lymph node metastasis. Multivariate Logistic regression analysis was used to screen the risk factors of TNBC complicated with axillary lymph node metastasis. R software was used to establish a nomogram model for predicting TNBC complicated with axillary lymph node metastasis, and the effectiveness of the model was verified.Results: Among 165 patients with TNBC, the incidence of axillary lymph node metastasis was 26.67% (44/165). There was no significant difference in age, residence, education, menstrual status, body mass index, family history of breast cancer, tumor location, vascular invasion, enhancement rate (V1), and area under the curve (TIC-AUC) between metastatic and non-metastatic groups (P>0.05). There were significant differences in tumor diameter, histological grade, proliferation index (Ki-67), contrast-enhanced ultrasound onset time (IT), peak time (TTP) and peak intensity (PI) (P<0.05). Multivariate Logistic regression analysis showed that the tumor diameter >2cm, histological grade Ⅲ, Ki-67>14% and PI were risk factors for axillary lymph node metastasis complicated by TNBC, while IT and TTP were protective factors for axillary lymph node metastasis complicated by TNBC (P<0.05). The C-index of the nomogram model of TNBC complicated with axillary lymph node metastasis was 0.960 (95%CI: 0.946~0.974). The predicted value of the correction curve is basically consistent with the actual value. The area under ROC curve of the model was 0.940 (95%CI: 0.927~0.953). When the decision curve showed a threshold probability of 1%-100%, the net benefit value of TNBC with axillary lymph node metastasis predicted by the nomogram was higher.Conclusion: Tumor diameter, histological grade, Ki-67, IT, TTP, PI, etc. are all influencing factors of axillary lymph node metastasis complicated by TNBC. The nomogram model of TNBC complicated by axillary lymph node metastasis constructed based on contrast-enhanced ultrasound parameters has high clinical application value.