Objective To explore the effect of narrative nursing on the fear of cancer recurrence in patients with head and neck cancer radiotherapy. Methods Atotal of 60 patients in the Department of Radiotherapy for Head and Neck Cancer in Zhejiang Cancer Hospital from January 2020 to March 2021 were selected as the research subjects. According to random number table method, patients were divided into control group and observation group, 30 cases in each group. The control group was given routine nursing, and the observation group was given narrative nursing intervention. The level of cancer recurrence fear and psychological distress were compared between the two groups before and after intervention. Results Before intervention, there were no significant differences in fear of cancer recurrence score and distress thermometer (DT) score of psychological pain between the two groups (P＞0.05). After intervention,the fear score of cancer recurrence in observation group was lower than that in control group, the difference was statistically significant (P＜0.05). After intervention, the DT score of psychological pain in the observation group was lower than that in the control group, the difference was statistically significant (P＜0.05). After intervention, the proportions of poor relationship with medical staff, depression, fear, worry, stress, sleep problems, poor eating and fatigue in the observation group were lower than those in the control group, the differences were statistically significant (P＜0.05). Conclusion Narrative nursing intervention can reduce the level of fear of cancer recurrence in patients with head and neck cancer radiotherapy and reduce the level of psychological pain, which is worthy of application and promotion.