Objective To explore the effects of a picture book interactive reading health education program on preschool children with Obstructive Sleep Apnea (OSA) during the perioperative period. Methods Using convenience sampling, a total of 239 preschool children with OSA hospitalized between June and December 2023 and their caregivers were selected and divided into a control group of 118 children and an experimental group of 121 children chronologically. Both groups began receiving interactive reading health education one week before hospitalization, the control group used conventional health education materials, whereas the experimental group used 《the Children′s OSA Perioperative Health Education》 to conduct picture book interactive reading health education. Results Totally 115 children in the two groups completed the study. After the intervention, the incidence of post-traumatic stress disorder and preoperative anxiety scores in the experimental group were significantly lower than those in the control group; the pain scores of the experimental group were significantly lower than those of the control group at different time points, and the differences in time effect and time×group effects were statistically significant; the postoperative food intake on the first day and the amount of food and water (including milk) consumed on the second day in the experimental group were significantly higher than those in the control group; the differences in behavior change rate between the two groups on the 14th and 30th day after surgery were statistically significant (all P<0.05). Conclusion Implementing interactive picture book reading for health education is beneficial in reducing preoperative anxiety levels, alleviating postoperative pain, improving eating behavior, and reducing postope-rative behavioral changes in preschool children with OSA.