Objective To explore the effect of evidence-based nursing in elderly patients undergoing coronary artery bypass grafting. Methods From June 2016 to June 2018, 110 elderly patients aged 65 to 80 who underwent coronary bypass transplantation in cardiac surgery ward were selected by convenience sampling. The subjects were divided into control group (55 cases) and observation group (55 cases). The patients in the control group were given routine nursing method. The patients in the observation group were given evidence-based nursing according to routine nursing methods. The incidence of postoperative complications and the satisfaction of nursing care between the two groups were compared. Results The incidence of arrhythmia, mental disorder, respiratory tract infection, hypoxemia, knife-edge infection and pressure sore during mechanical ventilation were 15.3％(9/55),6.8％(4/55),7.5％(6/55), 12.1％(7/55),5.2％(3/55)in the observation group, 35.7％(21/55),27.1％(15/55),25.5％(25/55),12.7％(12/55),15.3％(9/55) in the control group, and the difference was statistically significant (χ2=2.423-17.476, P<0.05 or 0.01). The satisfaction degree was 96.36％(53/55)in the observation group, 81.82％(45/55) in the control group, and the difference was statistically significant (χ2 =5.9864,P<0.05). Conclusions Evidence-based nursing has a better effect in the nursing of elderly patients undergoing coronary artery bypass grafting, and it is worth popularizing in clinical nursing.