Objective To investigate the application effect of cluster nursing in auricular reconstruction surgery by retroauricular skin expansion method for microtia and its impact on satisfaction. Methods A total of 50 patients who underwent auricular reconstruction surgery by retroauricular skin expansion method for microtia admitted to our hospital from September 2022 to September 2023 were selected as the research subjects, and they were divided into control group and observation group according to the different nursing schemes, with 25 patients in each group. The control group was given conventional nursing, and the observation group was given cluster nursing. The surgical success rate, postoperative infection rate, nursing effect, nursing quality and satisfaction were compared between the two groups. Results The surgical success rate of the observation group (96.00%) was higher than that of the control group (88.00%), and the postoperative infection rate (4.00%) was lower than that of the control group (16.00%) (P<0.05). The total effective rate of nursing in the observation group was higher than that in the control group (P<0.05). The scores of scheme formulation, detail disposal, nursing attitude and management quality in the observation group were better than those in the control group (P<0.05). The satisfaction of the observation group was higher than that of the control group (P<0.05). Conclusion The application of cluster nursing intervention in patients undergoing auricular reconstruction surgery by retroauricular skin expansion method for microtia has a positive effect on improving the success rate and satisfaction of patients, meanwhile, it can improve adverse emotions and reduce the incidence of postoperative infections.