Objective To evaluate the value of intensive nursing detail management in intensive care unit (ICU) nursing. Methods In this prospective study, 100 ICU patients in Shiyan Maternal and Child Health Hospital between January 2019 and March 2020 were assessed for eligibility and recruited. They were concurrently randomly assigned (1 : 1) to receive either conventional nursing (control group) or intensive nursing detail management (study group). The clinical endpoint was the nursing efficiency. Results Intensive nursing detail management was associated with significantly higher scores in basic nursing, quality of nursing, and quality of management versus conventional nursing ( P < 0.05). Intensive nursing detail management resulted in a significantly higher adequate nursing rate (96.00%) versus conventional nursing (74.00%) ( P < 0.05). The patients given intensive nursing detail management had a shorter hospital stay versus those receiving conventional nursing ( P < 0.05). Intensive nursing detail management was associated with a higher nursing satisfaction rate (74.00%) versus conventional nursing (70.00%) ( P < 0.05). Conclusion Intensive nursing detail management is effective and safe in ICU nursing, so it is worthy of clinical application.