Objective To explore the effect of physical restraint reduction program in neurosurgical ICU patients. Methods A total of 263 patients hospitalized in the department of neurosurgical intensive care unit were assigned into a control group of 131 and an intervention group of 132 chronologically, receiving either conventional physical restraintmanagement or physical restraint reduction program respectively. Results The rates of physical restraint use and skin damage caused by restraint in the intervention group were significantly lower than those in the control group (P＜0.05,P＜0.01). There was no significant difference in unplanned extubation between the two groups (P＞0.05). Conclusion The implementation of restraint reduction program effectively reduces physical restraint use and skin damage in neurosurgical ICU patients, which is conducive to self-directed physical activity and recovery of patients.