****? **Objective:** To analyze the application effect of evidence-based nursing combined with risk assessment strategy in the prevention and control of complications after free flap surgery.? **Methods:** A total of 80 patients admitted from January 2025 to December 2025 were selected for the study and randomly divided into a control group and an experimental group, with 40 cases each. The control group received routine nursing care, while the experimental group was managed with evidence-based nursing based on risk assessment strategy. The incidence of complications, flap success rate, and patient quality of life were compared between the two groups.? **Results:** After different interventions were provided to the two groups, the experimental group showed a lower incidence of complications than the control group (p<0.05). The flap success rate was higher in the experimental group than in the control group (p<0.05), and the quality of life was also superior in the experimental group (p<0.05).? **Conclusion:** Implementing evidence-based nursing combined with risk assessment for patients after free flap surgery can reduce complications, improve flap success rates, and enhance patient quality of life.