To explore the effect of narrative nursing intervention on patients with esophageal, gastric, and intestinal cancers. Methods: A retrospective analysis was conducted on the clinical data of 103 patients with digestive tract malignant tumors admitted to our hospital from January 2022 to January 2024. According to the nursing intervention received by the patients, they were divided into a control group (n=51) and an observation group (n=52). The control group received routine nursing intervention, while the observation group received narrative nursing intervention in addition to the routine nursing intervention. The compliance behavior, negative emotional status, self-perceived burden, quality of life, and adverse reactions of the two groups were compared. Results: After intervention, the observation group showed higher scores in medication, exercise, dietary, and emotional regulation adherence than the control group (P<0.05). Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) for negative emotions decreased in both groups, with a greater reduction in the observation group (P<0.05). Economic, physical, and emotional burden levels also decreased more in the observation group (P<0.05). Quality of life scores in physiological, social/family, emotional, and functional conditions improved more in the observation group (P<0.05). Adverse reactions, including nausea, vomiting, fatigue, pain, gastrointestinal reactions, and insomnia, were less frequent in the observation group than in the control group (P<0.05). Conclusion: Narrative nursing intervention for patients with digestive tract malignant tumors can effectively improve patient compliance behavior, alleviate negative emotions, reduce self-perceived burden, promote the improvement of patient quality of life, and reduce the occurrence of related adverse reactions. However, the study is limited by its small sample size and single-center design, which may affect the generalizability of the findings. Further research with larger and more diverse populations is recommended.