Objective To observe the effect of rehabilitation nursing pathway in transjugular intrahepatic portosystemic shunt （TIPS）. Methods From January 2022 to December 2024， 160 patients with cirrhotic esophageal and gastric varices bleeding and intractable hydrothorax and ascites who underwent TIPS surgery were selected and randomly divided into path group and control group， with 80 cases in each group. The clinical treatment schemes of the two groups were consistent. The control group was given routine nursing， and the path group was intervened by rehabilitation nursing path model. Six-minute walking test （6 MWT） distance， Activity of Daily Living， ADL） scores， self-rating anxiety scale （SAS） and self-rating depression scale （SDS） scores， as well as the incidence of postoperative complications （hepatic encephalopathy and abdominal hemorrhage）， hospitalization days， hospitalization expenses and nursing satisfaction scores were compared between the two groups. Results The incidence of postoperative complications in the pathway group was 6.25%（5/80）， which was lower than that in the control group （16.25%， 13/80）. The 6MWT distance， ADL score， SAS score and SDS score in the path group were better than those in the control group， and the difference was statistically significant （P < 0.05）. The hospitalization days in the path group were （10.50 ± 2.50） days， which were shorter than those in the control group （12.70 ± 3.50） days. The hospitalization expense was （8.31 ± 0.71） million yuan， which was lower than that of the control group （8.92 ± 0.53） million yuan. The nursing satisfaction score was （93.90 ± 3.31）， which was higher than that of the control group （89.50 ± 4.21）， and the difference was statistically significant （P < 0.05）. Conclusion TIPS rehabilitation nursing path can effectively promote patients' rehabilitation， reduce medical costs and improve patients' satisfaction.