Objective To explore the clinical effect of cognitive behavioral nursing on patients with burn scar plastic surgery. Methods A total of 80 patients with burn scar plastic surgery admitted to Hunan Provincial People's Hospital/the First Affiliated Hospital of Hunan Normal University from January 2021 to May 2023 were randomly divided into reference group and experimental group according to the two-color ball method, with 40 patients in each group. The reference group was given routine nursing, and the experimental group was given cognitive behavioral nursing on the basis of the reference group. The negative emotions, psychological resilience, scar recovery effect and nursing satisfaction were compared between the two groups. Results After nursing, the SAS score [(36.71±4.16) scores] and SDS score [(36.75±5.23) scores] of the experimental group were lower than those of the reference group [(43.38±6.35) scores and (44.45±4.49) scores], the difference was statistically significant (P<0.05). After nursing the psychological resilience score of the experimental group was (71.35±12.70) scores, which was higher than (64.98±13.16) scores of the reference group, and the difference was statistically significant (P<0.05). The total effective rate of scar recovery in the experimental group was 95.00%, which was higher than 77.50% in the reference group, and the difference was statistically significant (P<0.05). The nursing satisfaction of the experimental group was 92.50%, which was higher than 75.00% of the reference group, and the difference was statistically significant (P<0.05). Conclusion Cognitive behavioral nursing meets the needs of patients with burn scar plastic surgery, improve their negative emotions and psychological resilience, improve the total effective rate of scar recovery, and has high patient recognition and satisfaction.