To analyze the effect of health guidance on wound healing and aesthetics of obese parturients undergoing cesarean section. Methods A total of 100 obese parturients admitted to the hospital from June 2022 to June 2023 were selected as the research objects. They were divided into control group and observation group by random number table method, with 50 parturients in each group. The control group was given perioperative nursing, and the observation group was given health guidance. The wound healing, scar condition and incision aesthetic satisfaction of the two groups were compared at 3 months after operation. Results The proportion of grade A wound healing in the observation group was higher than that in the control group, and the proportion of grade B wound healing and grade C wound healing were lower than that in the control group (P <0.05). The scores of VSS, OSAS and PSAS in the observation group were lower than those in the control group (P <0.05). The satisfaction of incision aesthetics in the observation group was 98.00%, which was higher than 80.00% in the control group (P <0.05). Conclusion Health guidance can effectively improve the wound healing effect of obese parturients with cesarean section, improve the wound scar, and the parturients are more satisfied with the aesthetics of the wound.