Objective To analyze the improvement effect of targeted nursing intervention on pruritus in elderly patients with eczema. Methods A total of 48 elderly patients with eczema admitted to Weihai Municipal Hospital Affiliated to Shandong University from January 2022 to September 2023 were randomly divided into control group and observation group, with 24 patientsin each group. The control group was given routine nursing intervention, and the observation group was given targeted nursing intervention. The psychological status [Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS)], nursing effect [Eczema Area and Severity Index (EASI), Engagement in Self-care Scale(ESCA)], compliance score and nursing satisfaction score were compared between the two groups. Results The scores of SDS and SAS in the two groups after nursing were lower than those before nursing, and those in the observation group were lower than those in the control group (P <0.05). The EASI score of the two groups after nursing was lower than that before nursing, and the ESCA score was higher than that before nursing, while the EASI score of the observation group was lower than that of the control group, and the ESCA score was higher than that of the control group (P <0.05). The scores of compliance and nursing satisfaction in the observation group were higher than those in the control group (P <0.05). Conclusion Targeted nursing intervention can improve the degree of pruritus in elderly patients with eczema, improve self-care ability, compliance and nursing satisfaction, which is worthy of clinical application.