Abstract: Objective To discuss the application and clinical value of systematic nursing based on music therapy in patients with severe pneumonia. Methods A total of 120 patients with severe pneumonia were selected and randomly divided into the observation group and the control group, with 60 cases in each group. The control group was given routine nursing measures. The observation group received systematic nursing intervention on the basis of routine nursing measures, i.e. providing the patients with music therapy and playing different music to relax them. The mental state and night sleeping quality of both groups were compared and the immune level and inflammatory factors were analyzed. Results The scores of SAS (39.83±5.24) and PSQI (9.52±1.89) in the observation group were significantly lower than the control group (47.46±5.69) and (10.21±2.36), the differences were statistically significant(all P<0.05). The levels of CD4⁺CD25⁺ Treg cell (2.79±1.23)% and CD8⁺CD28^-Treg cell (6.76±4.27)% in the observation group were significantly higher than the control group (2.21±0.98)% and (4.54±2.66)%, and the levels of TNF-α (62.32±10.48) ng/L and IL-10 (37.56±13.43) ng/L in the observation group were significantly lower than the control group(71.51±11.78) ng/L and (59.32±16.91) ng/L, the differences were statistically significant(all P<0.05). Conclusion Systematic nursing based on music therapy can significantly improve the mental state and sleep quality of patients with severe pneumonia, in addition to lowering inflammatory factors, thus improving inflammatory reaction in patients.