Objective: To investigate the impact of enhanced recovery after surgery (ERAS) nursing combined with limb training on knee joint function and neurological function after total knee arthroplasty in patients with knee osteoarthritis (KOA). Methods: Eighty-six patients with KOA after TKA were randomly divided into two groups, group A and group B, with 43 patients in each group. Group A was given ERAS nursing, and group B was given limb rehabilitation training combined with ERAS nursing. The changes in knee joint function and neurological function were observed. Results: There was no significant difference in the time to get out of bed for the first time, first bowel movement time after the surgery, hospital stay and hospital costs between the two groups (P 0.05). There was no significant difference in the excellent rate of Judet scores and Lysholm scores between the two groups (P 0.05). There was no significant difference in NIHSS scores between the two groups before the operation (P 0.05). Fifteen and thirty days after the operation, the NIHSS scores of the two groups both decreased, and the NIHSS scores of group B were lower than those of group A (P<0.05). After the nursing care, the scores of health knowledge level, selfcare concept, self-care responsibility and self-care skills in group B were higher than those in group A (P<0.05). The incidence of complications in group B during nursing was lower than group A (P<0.05). Conclusion: The enhanced recovery after surgery nursing combined with limb training has a better effect on KOA patients after TKA. It can significantly improve knee joint function, limb motor ability and neurological function, increase patients' cognition of disease and reduce the incidence of complications, compared with simple enhanced recovery after surgery nursing.