To analyze the effect of PDCA mode nursing on episiotomy rate and incision aesthetics of primipara. Methods From April 2022 to January 2023, 86 primipara admitted to Nanjing Medical University Affiliated Maternity Hospital/ Nanjing Maternal and Child Health Hospital were selected as the research objects. According to the random number table method, they were divided into control group and observation group, with 43 primipara in each group. The control group was given routine nursing, and the observation group was given PDCA mode nursing. The perineal lateral incision rate, perineal incision aesthetics and life ability score (ADL) were compared between the two groups. Results The episiotomy rate of the observation group was 13.95%, which was lower than 23.26% of the control group, and the difference was statistically significant (P <0.05). The incision aesthetic rate of the observation group was 95.35%, which was higher than 81.40% of the control group, and the difference was statistically significant (P <0.05). The ADL score of the observation group after intervention was (94.31±4.22) scores, which was higher than (83.13±4.60) scores of the control group, and the difference was statistically significant (P <0.05). Conclusion PDCA mode nursing can effectively reduce the episiotomy rate of primipara during delivery, and improve the incision aesthetics and living ability of perineal incision, which is worthy of clinical application.