Objective: To explore the effect of comprehensive nursing based on protection motivation theory in elderly patients with hypertension. Methods: The study period was from August 2023 to May 2025. During this period, 40 elderly patients with hypertension who visited the hospital were selected and divided into an observation group (comprehensive nursing based on protection motivation theory, n=20) and a control group (routine nursing, n=20) based on a random number table method. Nursing indicators were compared between the two groups. Results: After nursing, the diastolic blood pressure (80.12 ± 2.31 mmHg) and systolic blood pressure (136.05 ± 3.47 mmHg) in the observation group were significantly different from those in the control group (P < 0.05). The scores of health behaviors (nutrition, exercise, health responsibility, and psychological comfort) in the observation group were higher than those in the control group (P < 0.05). After nursing, the scores of compliance and negative emotional indicators in the observation group were better than those in the control group (P < 0.05). The scores of psychological function (66.31 ± 5.84), physical function (66.57 ± 6.28), material function (61.85 ± 6.21), and social function (69.51 ± 7.25) in the observation group were higher than those in the control group (P < 0.05). Conclusion: During the treatment of elderly patients with hypertension, the application of a comprehensive nursing program based on protection motivation theory is beneficial for regulating blood pressure levels, significantly improving health behaviors and quality of life, alleviating negative emotions, and improving treatment compliance to some extent. This approach is feasible for promotion.