Abstract：Objective：To observe the nursing effect of five-element music therapy on patients with respiratory failure in intensive care unit. Methods： A total of 78 cases of patients with respiratory failure in intensive care unit were randomly divided into two groups， 39 cases in each group. The control group was given routine intensive care measures， and the experiment group was additionally given five-element music therapy based on the routine measures. Before and after twoweek nursing，partial pressure of oxygen(PaO2) and partial pressure of carbon dioxide(PaCO2) of arteries，as well as the total effective rate and satisfaction of clinical nursing were observed in the two groups. Results：Before nursing，there was no significant difference being found in the comparison of PaO2 and PaCO2 between the two groups(P＞0.05). After two- week nursing， in the experiment group， PaO2 was significantly increased when compared with that in the control group， and PaCO2 was significantly decreased，the difference being significant(P＜0.05). The total effective rate in the control group was significantly lower than that in the experiment group，the difference being significant(P＜0.05). Conclusion：In the treatment of patients with respiratory failure in intensive care unit，five-element music therapy has significant clinical effect，which can increase PaO2，decrease PaCO2，and effectively improve the total effective rate and satisfaction of clinical nursing.