Objective: To summarize the nursing priorities and intervention measures in the Phase I clinical trial of neural stem cell transplantation for the treatment of ischemic brain injury, providing a reference for clinical perioperative nursing practice. Methods: A retrospective analysis was conducted on the clinical nursing data of nine patients with ischemic brain injury who underwent intracranial stereotactic neural stem cell transplantation in the neurosurgery department of the hospital from January 2025 to June 2025. Comprehensive and meticulous perioperative nursing was implemented, covering preoperative condition assessment, psychological intervention, preoperative preparation, intraoperative positioning management, vital sign monitoring, surgical coordination, postoperative positioning care, multi-indicator dynamic monitoring, complication prevention and control, medication management, and individualized early rehabilitation guidance. The completion of the surgery, the occurrence of complications, and the improvement in the patients’ consciousness, limb function, neurological function, and activities of daily living (ADL) were observed and compared before surgery and 1–6 months after surgery. Results: All nine patients successfully completed the surgery. Postoperatively, two patients developed mild intracranial edema, and one patient experienced bleeding at the puncture site; all recovered after symptomatic nursing, with no serious complications occurring, and the overall complication rate was 30.0%. Within 24 hours after surgery, the vital signs of all patients stabilized; six patients regained consciousness within 3 hours after surgery, and three patients regained clear consciousness within 5 hours after surgery. One month after surgery, the National Institutes of Health Stroke Scale (NIHSS) scores of the patients were significantly lower than those before surgery, while the Glasgow Coma Scale (GCS) scores, limb muscle strength scores, and Barthel Index scores were significantly higher than those before surgery, with statistically significant differences (P<0.05). During the period of immunosuppressant application after surgery, no obvious adverse drug reactions occurred, and the patients tolerated the medications well. Conclusion: For patients with ischemic brain injury treated with neural stem cell transplantation, implementing comprehensive and meticulous perioperative nursing interventions can effectively ensure the smooth implementation of surgery, reduce the incidence of postoperative complications, promote the recovery of consciousness, limb, and neurological function, and improve ADL, which has important clinical value in improving the treatment effect and prognosis of patients.