Objective To explore the effect of aesthetic nursing under the concept of demand orientation on postoperative aesthetic effect in children undergoing cleft lip and palate repair. Methods A total of 82 children who received cleft lip and palate repair in General Hospital of Ningxia Medical University from January 2021 to December 2024 were selected, and they were divided into the control group and the observation group by the random number table method, with 41 children in each group. The control group received conventional nursing intervention, and the observation group received aesthetic nursing under the concept of demand orientation on the basis of the control group. The wound healing time, hospitalization time, postoperative aesthetic effect, sleep quality and psychological status of children's parents were compared between the two groups. Results The wound healing time and hospitalization time of the observation group were shorter than those of the control group (P<0.05). The scores of all dimensions of aesthetic effect in the observation group were better than those in the control group (P<0.05). The sleep quality of the observation group after intervention was better than that of the control group (P<0.05). The psychological status scores of children's parents in the observation group after intervention were better than those in the control group (P<0.05). Conclusion Aesthetic nursing under the concept of demand orientation has a deffnite effect on children undergoing cleft lip and palate repair. It can improve postoperative aesthetic effect, shorten wound healing time and hospitalization time, and relieve the psychological stress of children's parents, which is worthy of clinical application.