Objective: To explore the effect of predictive nursing based on risk identification theory in neonates with PICC. Methods: From November 2024, our hospital began to collect the neonatal case data of PICC catheterization in pediatrics. By November 2025, a total of 84 cases were included, and they were randomly divided into two groups by the method of drawing single and double numbers. Among them, 42 cases were given routine catheterization nursing as the reference group; Another 42 cases were treated with predictive nursing based on risk identification theory as the experimental group. The bleeding, swelling degree, nursing quality score, and complications were compared between the two groups. Results: The ratio of 0-I grade bleeding and 0-I grade swelling in the experimental group was significantly higher than that in the reference group (P<0.05). The scores of nursing quality in the experimental group were significantly higher than those in the control group (P<0.05). The total incidence of complications in the experimental group was 4.76%, which was significantly lower than that in the reference group (16.67%) (P<0.05). Conclusion: Predictive nursing based on risk identification theory can obviously reduce bleeding and swelling at the puncture point and improve the nursing quality, which should be actively promoted.