This study was conducted to explore the effects of comprehensive noise reduction management combined with reality therapy on anxiety and depression in hospitalised patients with breast cancer.The medical records of 166 inpatients with breast cancer in Tongji Hospital affiliated with Tongji Medical College of Huazhong University of Science and Technology from March 2020 to March 2022 were retrospectively analysed. According to different intervention methods, these patients were divided into group A (n = 58, receiving conventional intervention), group B (n = 55, receiving conventional intervention combined with reality therapy) and group C (n = 53, receiving conventional intervention combined with comprehensive noise reduction management and reality therapy intervention). Patients' anxiety and depression, quality of life and satisfaction degree in the three groups were compared.Before the intervention, the scores of the Hospital Anxiety and Depression Scale (HADS) and Short-From-36 Health Survey (SF-36) scale did not significantly differ amongst the three groups (P > 0.05). After the intervention, we observed a difference in the pairwise comparison of HADS scores amongst the three groups, in which group C had the lowest score and group A had the highest HADS score (P < 0.001). We also noted a difference in the pairwise comparison of SF-36 scores amongst the three groups, in which group C had the highest SF-36 score and group A had the lowest SF-36 score (P < 0.001). The pairwise comparison of satisfaction revealed a difference amongst the three groups, in which group C had the highest satisfaction (92.45%, 94.34% and 94.34%), and group A had the lowest satisfaction (74.14%, 74.14% and 75.86%; P < 0.05).Comprehensive noise reduction management combined with reality therapy can effectively relieve the negative emotions of inpatients with breast cancer, as well as improve their survival state of patients. It is suggested that it be included in the clinical intervention system for breast cancer.