Objective: To observe the effects of music therapy on negative psychology, sleep, and quality of life in elderly patients recovering from cerebral infarction accompanied by depression and anxiety. Methods: We performed a retrospective analysis of 160 patients with convalescent cerebral infarction diagnosed between December 2022 and December 2023 in the Affiliated Brain Hospital of Nanjing Medical University. Cases from the control group (n = 76) were treated with conventional rehabilitation training. Meanwhile, the music therapy group (n = 84) cases were managed with standard and music therapy. Various measures, including polysomnography, the general quality of life questionnaire-74 (GQOL-74), the self-rating anxiety scale (SAS), and the self-rating depression scale (SDS) were collected at baseline (admission) and 4 weeks post-admission. Results: After 4 weeks, the music therapy group exhibited higher GQOL-74 scores, lower SAS scores, and lower SDS scores (P < 0.001). Furthermore, compared with the control group, the music therapy group had shorter sleep latency, longer sleep duration, higher sleep efficiency, lower wake time, fewer wake times, shorter S1 stage, longer S3 + S4 stage, and longer REM period (P < 0.001). Conclusions: Music therapy appears to be effective in improving negative psychology, sleep quality, and quality of life in elderly patients with comorbid depression and anxiety during recovery from cerebral infarction.