The coupling effect of negative bias temperature instability (NBTI) and total ionizing dose (TID) was investigated by simulation based on the fully depleted silicon on insulator (FDSOI) PMOS. After simulating the situation of irradiation after NBT stress, it was found that the NBTI effect weakens the threshold degradation of FDSOI PMOS under irradiation. Afterward, NBT stress was decomposed into high gate voltage stress and high-temperature stress, which was applied to the device simultaneously with irradiation. The devices under high gate voltage exhibited more severe threshold voltage degradation after irradiation compared to those under low gate voltage. Devices at high temperatures also exhibit more severe threshold degradation after irradiation compared to devices under low temperatures. Finally, the simultaneous effect of high gate voltage, high temperature, and irradiation on the device was investigated, which fully demonstrated the impact of the NBT stress on the TID effect, resulting in far more severe threshold voltage degradation.