The invention provides a plan implementation method and apparatus based on predicted dose guidance and Gaussian process optimization, and relates to the field of radiotherapy technology. The method comprises: calculating a predicted dose of a case by using a dose prediction model; calculating a plan score of the predicted dose according to the scoring rule as an optimal plan score; determining a plurality of sets of plan parameters based on the a priori database according to organ anatomy information; calculating corresponding plan scores of the plurality of sets of plan parameters, and constituting a Gaussian data set; and based on the Gaussian data set, calculating new plan parameters by using the Gaussian process, calculating the corresponding plan scores, adding the calculated scores to the Gauss data set, iteratively executing the step, and finally calculating the intensity-modulated optimization results under the plan parameters corresponding to the highest score in the Gauss data set. By the use of the predictive model to predict the dose distribution of the case to optimize the guidance, the quality of the plan is guaranteed, and by the use of the Gaussian process to calculate the posterior distribution based on the a priori data, the number of trial and error is reduced, thereby speeding up the optimization.