Objective To investigate the effect of pathway-guided cardiac rehabilitation nursing on patients after percutaneous coronary intervention (PCI) for acute myocardial infarction. Methods A total of 112 patients who were admitted to The Affiliated Hospital of Xuzhou Medical University from January 2021 to December 2023 and underwent PCI for acute myocardial infarction were enrolled and divided into study group and control group using the envelope method, with 56 patients in each group. The patients in the control group received routine nursing, while those in the study group received pathway-guided cardiac rehabilitation nursing in addition. The application effect was compared between the two groups. Results Compared with the control group, the study group had significantly higher left ventricular ejection fraction, Barthel Index for activities of daily living, and six-minute walk test score and significantly lower incidence rate of adverse cardiovascular events, disease recurrence rate, and scores of Hamilton Anxiety Scale and Self-Rating Anxiety Scale, as well as significantly shorter length of hospital stay and time to first ambulation (P<0.05). Conclusion Pathway-guided cardiac rehabilitation nursing has a good application effect in patients after PCI for acute myocardial infarction and can enhance their cardiac function, assist in improving their physiological life status, alleviate negative emotions, and reduce the risk of adverse cardiovascular events and disease recurrence after PCI, with a relatively high level of practicality.