Abstract: Objective: To explore the application effectiveness of the “Six-Step” Scenario-Based Teaching Method in operating room nursing education. Methods: Seventy nursing students undergoing clinical training in the operating room of a certain hospital from January 2024 to June 2025 were selected. They were randomly divided into an observation group (n = 35) and a control group (n = 35) using a random number table. The control group received traditional “mentor-apprentice” on-the-job training, while the observation group underwent the “six-step” scenario-based teaching method. The two groups were compared on final assessment scores, comprehensive competency, surgical nursing emergency response ability, and teaching satisfaction indicators. Results: The observation group achieved significantly higher final assessment scores (85.54 ± 5.05) than the control group (78.63 ± 4.75); After instruction, the observation group scored significantly higher than the control group in: mastery of basic duties and procedures (4.22 ± 0.30 vs. 3.98 ± 0.30), understanding of surgical nursing essentials (4.39 ± 0.19 vs. 3.98 ± 0.30), proficiency in surgical assistance (4.11 ± 0.33 vs. 3.98 ± 0.30), aseptic awareness (4.32 ± 0.24 vs. 3.98 ± 0.30), risk awareness (4.22 ± 0.17 vs. 3.98 ± 0.30), and occupational safety awareness (4.01 ± 0.23 vs. 3.98 ± 0.30). (4.01 ± 0.23), which were significantly higher than the control group’s scores (3.36 ± 0.28), (3.14 ± 0.27), (3.29 ± 0.24), (3.53 ± 0.36), (3.17 ± 0.25), and (3.51 ± 0.18), respectively. Students in the observation group scored significantly higher than the control group in emergency hands-on skills (24.53 ± 1.85 points), surgical coordination skills (27.65 ± 1.87 points), emergency coordination skills (25.34 ± 1.83 points), and patient condition observation skills (24.34 ± 1.79 points) were significantly higher than those of the control group (20.78 ± 1.74 points, 26.31 ± 1.95 points, 22.92 ± 1.69 points, and 21.58 ± 1.77 points, respectively). The satisfaction rate with operating room nursing education among students in the observation group (97.00%) was significantly higher than that in the control group (77.00%). All differences were statistically significant (p < 0.05). Conclusion: The “Six-Step” Scenario-Based Teaching Method effectively enhances operating room students’ mastery of theoretical knowledge, practical skills, and core comprehensive abilities, while significantly improving their teaching satisfaction. It warrants promotion and application in operating room nursing education.