Objective To evaluate the clinical value of nursing interventions based on risk assessment strategies for the prevention of postoperative infections in patients undergoing total abdominal hysterectomy. Methods The clinical data of patients undergoing total abdominal hysterectomy in Anyang Maternal and Child Health Care Hospital from January 2022 to May 2023 were retrospectively collected. According to different nursing methods, they were divided into study group (n=39) and control group (n=39). The control group received routine nursing interventions, while the study group received nursing interventions based on a risk assessment strategy. The incidence of postoperative infection and other complications, perioperative indexes, discharge readiness and quality of life scores were compared between the two groups. Results The incidence of postoperative infection in the study group (5.13%) was lower than that in the control group (20.51%), with statistically significant differences (P<0.05). There was no statistical significant difference in the incidence of abdominal bloating, poor wound healing, and deep vein thrombosis in the lower limbs between the two groups (P>0.05). The time to first flatus, time to ambulation, time to start consuming liquids, and time to bowel movement were all shorter in the study group compared to the control group, with statistically significant differences (P<0.05). The RHDS score of the research group (165.54±10.65) was significantly higher than that of the control group (156.78 ±12.14), with statistically significant differences (t=3.388, P=0.001). There were statistically significant differences in quality of life scores across various dimensions between the two groups, as well as in time, inter-group, and interaction comparisons (P<0.05), with the study group scoring higher in all dimensions than the control group (P<0.05). Conclusion Nursing interventions under the risk assessment strategy for patients undergoing total abdominal hysterectomy have significant advantages in controlling postoperative infections, promoting postoperative recovery, improving discharge readiness, and enhancing postoperative quality of life. It can provide important theoretical basis and practical data support for designing an intelligent management system for postoperative infection risk after total abdominal hysterectomy.