Objective To analyze the effect of medical beauty nursing management combined with psychological counseling intervention for plastic and cosmetic outpatients. Methods From January 2023 to February 2024, 60 plastic and cosmetic outpatients in our hospital were selected as the research objects. According to the random number table method, they were divided into control group (n =30) and experimental group (n =30). The control group was treated with medical and aesthetic nursing management, and the experimental group was combined with psychological counseling intervention on the basis of the control group. The nursing effect, negative emotion, vital signs, MCMQ score and nursing satisfaction of the two groups were compared. Results The scores of service attitude, service consultation, outpatient environment, waiting for treatment and overall image in the experimental group were higher than those in the control group, and the differences were statistically significant (P <0.05). After nursing, the scores of HAMA and HAMD in the experimental group were lower than those in the control group, the differences were statistically significant (P <0.05). The levels of respiratory rate, heart rate and systolic blood pressure in the experimental group were lower than those in the control group, and the differences were statistically significant (P <0.05). The confrontation score of the experimental group was higher than that of the control group, and the yield and avoidance scores were lower than those of the control group, the differences were statistically significant (P <0.05). The nursing satisfaction of the experimental group was 96.67%, which was higher than 80.00% of the control group, and the difference was statistically significant (P <0.05). Conclusion Medical beauty nursing management combined with psychological counseling intervention can give plastic surgery outpatients professional nursing support, pay attention to the psychological emotions of patients during treatment, make them more active and active in treatment, improve patient compliance, maintain stable vital signs, and ensure the orderly development of treatment.