Objective To explore the effect of rehabilitation nursing under the guidance of behavioral change theory in patients with scar plastic surgery after burn. Methods A total of 74 patients with scar plastic surgery after burn admitted to our hospital from August 2023 to August 2024 were selected as the research subjects, and they were divided into control group and observation group according to the random number table method, with 37 patients in each group. The control group was given conventional nursing, and the observation group was given rehabilitation nursing under the guidance of behavioral change theory. The recovery, psychological state, self efficacy, social support and nursing satisfaction were compared between the two groups. Results The scores of scar, VAS and BIRS-C in the observation group were lower than those in the control group, and the scores of CD-RISC, GSES and all dimensions of social support were higher than those in the control group (P <0.05). The nursing satisfaction in the observation group was higher than that in the control group (P <0.05). Conclusion The implementation of rehabilitation nursing under the guidance of behavioral change theory for patients with scar plastic surgery after burn is helpful to reduce the psychological pressure, enhance the self efficacy. It can also improve the social support and promote the rehabilitation, and patients’ nursing satisfaction is higher.