Objective: To analyze the characteristics of stress symptoms before and after surgery in adolescent idiopathic scoliosis (AIS) patients and their correlation with postoperative pain. Methods: Fifty-four AIS patients aged 13-18 years from January 2015 to June 2018 in Foshan Traditional Chinese Medicine Hospital were selected. The anxiety, stress and stress symptoms of the patients before and 6 months after operation were assessed by the Trauma Symptom Checklist for Children-Alternative version (TSCC-A) and the Youth Self-Report (YSR). The pain was assessed by Visual Analogue Scale. The correlation between the stress symptoms of the patients and postoperative pain were analyzed by linear regression equation. Results: The score of anxiety/depression and internalization problems in YSR before operation was (5.40±2.48) and (12.19±4.67) respectively, and 6 months after operation, the score was (4.10±1.92) and (9.81±3.46) respectively, there were significant differences between preoperative and 6 months after operation (t value was 7.266, 8.107, P < 0.05). Before operation, the scores of anger in TSCC-A, the scores of social problems and attention problems in YSR were positively correlated with postoperation pain (P < 0.05), while postoperation pain was positively correlated with the scores of anxiety in TSCC-A, the scores of social problems and attention problems in YSR 6 months after operation (P < 0.05). Conclusions Preoperative stress symptoms of AIS patients are associated with postoperative pain, while postoperative pain is associated with postoperative recovery anxiety. Preoperative intervention should be actively taken to reduce perioperative stress symptoms and postoperative pain, so as to further improve the quality of nursing.