Objective To explore the effects of an empowerment nursing model guided by stress system theory on psychological stress and quality of life in patients with stable angina pectoris (SAP). Methods A prospective cohort study was conducted involving 92 SAP patients treated at Anyang People’s Hospital from May 2023 to May 2025. The patients were divided into a control group and an observation group with 46 cases in each group by the random number table method. The control group received routine nursing intervention, while the observation group received empowerment nursing guided by stress system theory. The intervention efficacy was evaluated after 3 months of intervention. Indicators including self-management ability, psychological resilience assessed by the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), symptom control status, and quality of life scored by the Seattle Angina Questionnaire (SAQ) were compared between the two groups. Results After intervention, the scores of self-management ability, CD-RISC-10 psychological resilience and SAQ in the observation group were all significantly higher than those in the control group (all P＜0.05). The frequency of angina pectoris attacks was remarkably lower and the attack duration was shorter compared with the control group (all P＜0.05). Conclusion The empowerment nursing model guided by stress system theory can significantly improve self-management ability and psychological resilience of SAP patients, reduce angina attacks and effectively control symptoms, so as to elevate patients’ quality of life.