Objective To evaluate the clinical effect of intelligent pulse cold compress device in pain management after arthroscopic rotator cuff repair (ARCR), and to explore the application value of supporting nursing intervention mode. Methods The clinical data of 86 patients who underwent ARCR in Xiaoshan Hospital of Traditional Chinese Medicine from January 2022 to December 2024 were retrospectively analyzed. According to the postoperative cold compress method, they were divided into observation group (n＝ 43, intelligent pulse cold compress device＋standardized nursing intervention) and control group (n＝43, traditional ice pack cold compress＋routine nursing). Moreover, both groups were followed up until 2 weeks postoperatively. The differences in pain severity [numerical rating scale (NRS)], swelling degree (upper arm circumference difference), additional analgesic use (within 48 h after surgery), Constant-Murley shoulder joint function score (CMS), and nursing satisfaction between the two groups were compared. And the occurrence of complications such as frostbite and numbness were also recorded. Results Before the intervention (2 h after operation), there was no statistically significant difference in the NRS scores between the two groups (P＞0.05); at 24, 48, and 72 h after operation, the NRS scores of the observation group were lower than those of the control group (all P＜0.05); in the same group, at 24, 48, and 72 h after operation, the NRS scores were lower than those before the intervention (2 h after operation) (all P＜0.05). At 24, 48 h after operation, the upper arm circumference difference of the observation group were significantly smaller than that of the control group (all P＜0.001). The additional analgesic rate in the observation group within 48 h was lower than that in the control group (P＝0.034). At 2 weeks after operation, the CMS was higher in the observation group than that in the control group (P＜0.001), and the nursing satisfaction was higher in the observation group than that in the control group (P＜0.05). There were no serious complications such as frostbite and nerve compression in both groups. Conclusion Intelligent pulse cold compress device combined with standardized nursing intervention can effectively relieve pain, reduce swelling degree, reduce the use of analgesics and promote early functional recovery of patients after ARCR.