Objective To explore the application effect of precise nursing intervention based on pain trajectory in school-age children with limb fractures. Methods A quasi experimental study design was used to divide 116 school-age children with limb fractures who were scheduled for surgical treatment into a control group and an intervention group chronologically, with 58 cases in each group. The control group received routine perioperative care, while the intervention group additionally received precise nursing intervention based on pain trajectory. The pain scores within 48 hours after injury and within 72 hours after surgery, and the functional exercise compliance on the second day after surgery were compared between the two groups. Results The pain scores of the intervention group were significantly lower at various time points after injury and 8-72 hours after surgery when compared with those of the control group, and its compliance with functional exercise was significantly higher than that of the control group (all P<0.05). Conclusion Implementing the precise nursing intervention based on pain trajectory for school-age children with limb fractures can effectively reduce their degree of pain, improve postoperative functional exercise coordination, and promote rapid limb recovery.