[Objective] To investigate the effect of intermittent cold therapy on postoperative occult blood loss in patients with thoracolumbar fracture undergoing open reduction and internal fixation. [Methods] Sixty-six patients who underwent open reduction and internal fixation for thoracolumbar fracture admitted to the Department of Spine Surgery, Huaian First Hospital Affiliated to Nanjing Medical University from January 2021 to November 2022 were included for analysis and discussion, and were randomly divided into two groups by random number table method, including observation group (33 cases) and control group (33 cases). The observation group received intermittent cold therapy for postoperative nursing intervention, and the control group received routine nursing intervention. Total blood loss, erythrocyte volume decline and recessive blood loss were compared between the two groups. [Results] The total blood loss, erythrocyte volume reduction and recessive blood loss in the observation group were significantly lower than those in the control group, with statistical significance (P < 0.05). [Conclusion] Intermittent cold therapy has a positive significance in reducing the postoperative recessive blood loss of patients with thoracolumbar fracture, and can significantly reduce the total blood loss, decrease in red blood cell volume and recessive blood loss of patients after open reduction and internal fixation of fractures. It is conducive to the early postoperative rehabilitation and early functional exercise of patients while reducing the postoperative blood transfusion rate.