Purpose: To investigate the effects of postoperative exercise rehabilitation nursing intervention on the prevention and management of multiple organ dysfunction syndrome (MODS) in thoracic surgery patients. Methods: A total of 224 patients who underwent thoracic surgery at a tertiary hospital in The First College of Clinical Medical Science, China Three Gorges University and Yichang Central People’s Hospital, Yichang, China. province from October 1, 2021, to March 10, 2023, were selected and randomly divided into a control group and an observation group, with 112 cases in each group. The control group received routine nursing care, while the observation group received postoperative exercise rehabilitation nursing intervention in addition to routine nursing care measures. The lung function scores, incidence of multiple organ dysfunction, self-management levels, and postoperative recovery time were observed and compared between the two groups. Results: Before nursing intervention, there were no significant differences in lung function parameters (FEV1/FVC, respiratory rate, and oxygen saturation) between the two groups (P>0.05). After nursing intervention, both groups showed significant changes in lung function parameters compared to before intervention (P<0.05), with the observation group showing significantly better lung function levels than the control group (P<0.05). The incidence of MODS in the observation group (2 cases, 1.79%) was significantly lower than that in the control group (9 cases, 8.04%) after nursing intervention (P<0.05). The ESCA score and ADL score in both groups were significantly higher after nursing intervention compared to before (P<0.05). The ESCA score and ADL score in the observation group (133.53±10.52 and 49.35±7.56, respectively) were significantly higher than those in the control group (41.75±7.64 and 121.47±10.04, respectively) after nursing intervention (P<0.05). The postoperative recovery time in the observation group (13.31±2.20 hours for first time out of bed, 19.31±2.20 hours for first time passing gas, and 33.01±2.20 hours for first time defecation) was significantly shorter than that in the control group (14.28±2.60 hours, 20.43±2.89 hours, and 34.62±2.88 hours, respectively) (P<0.05). Conclusion: Exercise rehabilitation nursing intervention can promote improvement in lung function levels in patients after thoracic surgery, prevent the occurrence of postoperative MODS, and improve patient self-management levels. This has important implications for improving treatment outcomes and enhancing quality of life.