Objective To systematically review prediction models for the risk of oral mucosa pressure injury in ICU patients with orotracheal intubation，aiming to assist clinical healthcare professionals in selecting or designing appropriate assessment tools. Methods We systematically searched PubMed，Embase，Web of Science，Cochrane Library，CINAHL，China National Knowledge Infrastructure，VIP Database，Wanfang Database，and China Biological Medicine Literature Database for studies published from database inception to February 1，2025，focusing on the development of risk prediction models for oral mucosa pressure injuries in ICU patients with orotracheal intubation. Two researchers independently performed literature screening and data extraction. The Prediction model Risk of Bias Assessment Tool（PROBAST） was applied to assess the risk of bias in the included studies. Results Ten studies involving 10 distinct prediction models were included. The top five most frequently reported predictor variables were duration of intubation，albumin level，acute physiology and chronic health evaluationⅡ（APACHEⅡ），Richmond Agitation-Sedation Scale score（RASS），and bite block usage. Eight studies reported area under the receiver operating characteristic curve（AUC） values ranging from 0.600 to 0.930. While the applicability of all ten studies was rated as good，they universally exhibited a high risk of bias，particularly in the domain of analysis. Conclusion Research on prediction models for oral mucosa pressure injury risk in ICU patients with orotracheal intubation remains in its early stages. Future studies should focus on conducting high-quality research，incorporating artificial intelligence to optimize model development and clinical translation. Emphasis should be placed on strengthening both internal and external validation of models，with particular attention to core predictors such as duration of intubation，APACHE Ⅱ score，and bite block usage.