Objective: For elderly patients, painless gastrointestinal endoscopy can easily induce adverse events. We aimed to evaluate the effects of high-quality nursing interventions on the outcomes and complication rate of elderly patients undergoing painless gastrointestinal endoscopy. Methods: A total of 124 patients who received painless gastrointestinal endoscopy from January to December 2022 were selected, 62 of whom admitted between January and June 2022 were included into a conventional nursing group and given traditional basic nursing intervention, and the other 62 admitted between July and December 2022 were assigned into a high-quality nursing group and given high-quality nursing intervention. The intervention outcomes were compared. Results: The Self-rating Anxiety Scale and Self-rating Depression Scale scores of the high-quality nursing group were lower than those of the conventional nursing group (P<0.05). The systolic blood pressure, diastolic blood pressure, and heart rate during and after diagnosis and treatment decreased in the high-quality nursing group compared with those in the conventional nursing group (P<0.05). The high-quality nursing group had a lower complication rate and a higher nursing satisfaction rate than those of the conventional nursing group (P<0.05). Conclusion: High-quality nursing intervention not only stabilizes the psychological state of elderly patients undergoing painless gastrointestinal endoscopy, but also is beneficial to maintaining stable blood pressure and heart rate.