Background: The aim of the study was to investigate the levels of a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS13), total bilirubin (TBIL), and D-dimer (D-D) in thrombotic thrombocytopenic purpura (TTP) and their values for predicting the prognosis. Methods: The clinical data of 89 TTP patients admitted from March 2018 to December 2021 were collected for retrospective analysis. They were assigned to remission group (n = 61) and death group (n = 28) according to clini-cal outcomes. General clinical data were compared between the two groups. Predictors with non-zero coefficients were screened by LASSO regression analysis, and influencing factors were identified by logistic regression analy-sis. Then the risk factors were incorporated to construct a nomogram model, which was validated subsequently. Bivariate Pearson's correlation analysis was employed to analyze the correlations. The receiver operating charac-teristic curves were plotted to analyze the values of ADAMTS13, TBIL, and D-D for predicting the prognosis of TTP. Results: TBIL > 72.74 mu mol/L, D-D > 4.17 mg/L, PLASMIC score < 6 points, and absence of plasma exchange (PEx) were risk factors affecting the prognosis, and ADAMTS13 <= 25.04% was a protective factor for the progno-sis of TTP patients (p < 0.05). ADAMTS13, TBIL, and D-D were significantly associated with death (p < 0.05). The areas under the curves of TBIL, ADAMTS13, D-D and their combination were 0.796 (95% confidence interval CI: 0.729 -0.860), 0.721 (95% CI: 0.648 -0.788), 0.820 (95% CI: 0.756 -0.880), and 0.872 (95% CI: 0.823 -0.920), respectively.