Objective To investigate the impact of evidence-based nursing respiratory rehabilitation intervention on pulmonary function, daily activity ability, and quality of life in elderly patients with chronic obstructive pulmonary disease (COPD), and to provide a reference for clinical rehabilitation nursing pathways. Methods A total of 82 elderly patients with stable-stage COPD admitted to Guangzhou Chest Hospital from June 2022 to June 2023 were enrolled and randomly divided into an experimental group and a control group, with 41 patients in each. The control group received routine nursing care, while the experimental group received respiratory rehabilitation intervention under the guidance of evidence-based nursing pathways in addition to routine care. The intervention lasted for 12 weeks. Changes in pulmonary function indicators (FEV1, FEV1/FVC), exercise capacity (6MWD), daily activity ability (Barthel index), quality of life (CRQ score), compliance, and nursing satisfaction were compared between the two groups before and after the intervention. Results After the intervention, the experimental group showed significantly greater improvements in FEV1, FEV 1/FVC, 6MWD, Barthel index, and CRQ scores in all dimensions compared to the control group (P<0.05). Moreover, the experimental group demonstrated higher compliance with the rehabilitation protocol and greater nursing satisfaction (P <0.05). Conclusion Evidence-based nursing respiratory rehabilitation intervention can effectively improve pulmonary function, exercise capacity, and self-care ability in elderly COPD patients, enhancing their quality of life and compliance with intervention. This approach has considerable clinical value and potential for widespread application.