Objective To explore the effect of incision pain nursing in cesarean section and its influence on surgical incision scar and aesthetics. Methods A total of 104 primiparas who underwent cesarean section in the obstetrics department of our hospital from July 2022 to July 2023 were randomly divided into control group and observation group, with 52 primiparas in each group. The control group was given routine nursing, while the observation group was given incision pain nursing on the basis of the control group. The scar severity, scar condition, pain degree, aesthetic satisfaction and incidence of incision complications were compared between the two groups. Results The PSAS and OSAS scores of the observation group were lower than those of the control group (P <0.05). The width and thickness of scar in the observation group were smaller than those in the control group (P <0.05). There was no significant difference in scar length between the two groups (P >0.05). The scores of PRI, VAS, PPI and total score in the observation group were lower than those in the control group (P <0.05). The aesthetic satisfaction in the observation group was 96.15%, whi ch was higher than 84.62% in the control group (P <0.05). The incidence of incision complications in the observation group was 3.85 %, which was lower than 17.31 % in the control group (P <0.05). Conclusion The application of incision pain nursing in cesarean section has a good effect, which can effectively reduce the severity and pain of scar, reduce the width and thickness of scar, help reduce the incidence of postoperative complications, improve aesthetic satisfaction, and promote post partum recovery.