Objective To explore the effect evaluation of choking risk assessment and intervention on the choking prevention of homeless inpatients with psychiatricc. Methods Totally 163 homeless inpatients with psychiatric disorder were selected from July 2012 to June 2016, 56 cases from July 2012 to December 2013 were assigned to the control group, another 107 cases from January 2014 to June 2016 was set as the intervention group. The control group received routine nursing safety management, on the basis of it, the intervention group received choking risk assessment through choking risk assessment scales. To take choking risk intervention on the patients of reached choking danger threshold. The incidence of choking and choking ending were compared between the two groups and the choking risk levels and scores in the intervention group before and after intervention were also compared. Results The incidence of choking in the intervention group and the control group was 0.93%(1/107)and 10.71%(6/56)respectively. Choking ending: 2 heal, 3 aspiration pneumonia, 1 death of 6 cases in the control group and 1 case was cured, no death and aspiration pneumonia occurred in the intervention group, the statistical differences were significant (χ2=9.399,18.554, P < 0.01 or 0.05). There were 28.0% (30/107) reached level Ⅰ, Ⅱ and Ⅲ choking threshold in the intervention group and rank mean of choking risk scores were 41.29. After interventions were 8.4% (9/107) and 25.50 respectively, the statistical differences were significant (χ2=10.231, P<0.05;Z=7.511, P<0.01). Conclusions The corresponding nursing intervention on the patients of choking risk can reduce and avoid choking accidents and protect the safety of homeless inpatients with psychiatric disorder effectively and improve the quality of care.