Objective To explore the effect of risk management combined with clinical nursing pathway in patients with lower limb burn skin grafting. Methods A total of 60 patients with lower limb burn skin grafting admitted to our hospital from April 2020 to February 2023 were selected as the research objects. They were divided into intervention group and control group by random number table method, with 30 patients in each group. The control group was given routine nursing intervention, and the intervention group was given risk management combined with clinical nursing pathway. The pain degree, quality of life and complications were compared between the two groups. Results The VAS score of the two groups after intervention was lower than that before intervention, and that in the intervention group was lower than that in the control group, the difference was statistically significant (P<0.05). The quality of life scores of each dimension in the two groups after intervention were higher than those before intervention, and those in the intervention group were higher than those in the control group, the difference was statistically significant (P<0.05). The incidence of complications in the intervention group was 6.67%, which was lower than 30.00% in the control group, and the difference was statistically significant (P<0.05). Conclusion The application of risk management combined with clinical nursing pathway in patients with lower limb burn skin grafting is effective, which can effectively reduce the pain, improve their quality of life, prevent the occurrence of related complications, and is worthy of clinical application.