Objective To explore the effect of nursing intervention based on PERMA model on psychosocial adaptation level in patients undergoing scar plastic surgery. Methods A total of 94 patients who underwent scar plastic surgery admitted to the Department of Microscopic Foot and Ankle Surgery, China Railway Fuyang Hospital from September 2023 to November 2024 were divided into the control group and the observation group by the random number table method, with 47 patients in each group. The control group received conventional nursing, and the observation group received nursing intervention based on PERMA model. The rehabilitation time, psychosocial adaptation level, psychological state, stigma, self-efficacy, sleep quality, quality of life and complications were compared between the two groups. Results The recovery time in the observation group was shorter than that in the control group (P <0.05). The scores of Psychosocial Adaptation to Illness Scale -Self Report (PAIS-SR), Hamilton Depression Scale (HAMD), Social Impact Scale (SIS), Pittsburgh Sleep Quality Index (PSQI) and complication rate in the observation group after nursing were lower than those in the control group (P <0.05). The scores of General Self-Efficacy Scale (GSES) and 36-Item Short Form Health Survey (SF-36) in the observation group after nursing were higher than those in the control group (P <0.05). Conclusion Nursing intervention based on PERMA model has a positive impact on improving psychosocial adaptation ability, psychological state and quality of life in patients undergoing scar plastic surgery.