Objective: To explore the effect of nursing risk management in patients with chronic hepatitis B liver failure (CHBLF). Methods: A total of 43 cases of patients with CHBLF were chosen as observation group in our hospital from June 2013 to February 2014 while 52 cases of patients with CHBLF were chosen as control group; the control group was given conventional nursing management while the observation group used nursing risk management, the hospitalization time, complications (hepatic encephalopathy, hepatorenal syndrome, gastrointestinal bleeding, secondary infection), the score of nursing quality, the incidence of nursing defects and patient satisfaction were observed in the two groups. Results: The incidence of hepatic encephalopathy, gastrointestinal hemorrhage, hepatorenal syndrome, secondary infection and more than two kinds of complication in observation group was lower than control group (P>0.05); the score of nursing quality and satisfaction were obviously higher than control group (P<0.05), while the incidence of nursing defects was significantly lower than control group (P<0.05). Conclusion: The implementation of nursing risk management on patients with CHBLF can effectively improve the nursing quality and satisfaction, and reduce the occurrence of nursing defect and complications.