Objective To explore the effect of health education based on information-motivation-behavioral skills (IMB) model on fall prevention knowledge, attitude, and practice(KAP) and fear of fall for elderly patients with breast cancer and their spouses. Methods A total of 96 elderly patients with breast cancer and their spouses were evenly divided into 2 groups. The control group received routine health education, while the intervention group received IMB model based health education. Before intervention, at the end of intervention and 3 months after intervention, the fall prevention KAP and fear of fall scores between the two groups were compared. Results A total of 45 cases in the control group and 46 cases in the intervention group completed the study. At completion and 3 months after intervention, there were significant differences in group effect, time effect, and group by time effect for the outcomes of fall prevention KAP and fear of fall scores between the 2 groups (P＜0.01 for all). Conclusion Health education of fall prevention based on IMB model can improve KAP level in elderly breast cancer patients and their spouses and reduce their fear of fall, which is of good practical value in clinical settings.