Objective To analyze the application effect of nursing model based on clinical pathway in patients undergoing total auricular reconstruction for congenital microtia. Methods A total of 98 patients with congenital microtia who underwent total auricular reconstruction in our hospital from July 2022 to July 2023 were selected as the research subjects. They were divided into the control group and the study group by the random number table method, with 49 patients in each group. The control group was given conventional nursing, and the study group was given nursing model based on clinical pathway. The recovery, negative emotions, aesthetic satisfaction of auricle shape, complications and pain degree were compared between the two groups. Results The postoperative activity time, hospitalization time and wound recovery time in the study group were shorter than those in the control group (P <0.05). After nursing, the scores of SAS and SDS in the study group were lower than those in the control group (P <0.05). The aesthetic satisfaction of auricle shape in the study group (93.88%) was higher than that in the control group (77.55%) (P <0.05). The incidence of complications in the study group (8.16%) was lower than that in the control group (24.49%) (P <0.05). The VAS scores at 3 days, 5 days after surgery, and at discharge in the study group were lower than those in the control group (P <0.05). Conclusion The application of nursing model based on clinical pathway in patients undergoing total auricular reconstruction for congenital microtia can effectively relieve postoperative pain, reduce the psychological pressure of patients. At the same time, it can reduce the risk of complications, and is beneficial to improving the aesthetic satisfaction of auricle shape. It is worthy of clinical application.