Objective To evaluate the improvement effects of high-quality nursing based on Noddings’ caring theory on symptom relief, blood gas indicators and nursing quality in children with pneumonia. Methods A total of 74 children with pneumonia admitted to the hospital from October 2025 to August 2026 were enrolled as study subjects, and were randomly classified into intervention group and control group, with 37 cases in each group. The control group implemented routine nursing of pediatric pneumonia, whereas the intervention group carried out high-quality nursing intervention based on Noddings’ caring theory on the basis of routine nursing. The differences in symptom relief indicators (fever abatement time, cough disappearance time, lung rale disappearance time, hospitalization time) and blood gas analysis indicators [partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), blood oxygen saturation (SpO2), pH value] before and after intervention were compared between both groups, and the differences in medication compliance, comfort degree [numerical rating scale (NRS)] and nursing satisfaction of family members were recorded and compared. Results The intervention group [(1.74±0.85) d, (3.62±1.03) d, (2.18±1.06) d, (4.08±0.29) d] demonstrated shorter fever abatement time, cough disappearance time, lung rale disappearance time and total hospitalization time compared to the control group [(2.25±1.02) d, (4.19±1.24) d, (2.73±1.11) d, (4.55±0.36) d] (P<0.05). After intervention, the PaO2, SpO2 and pH in the intervention group were significantly higher than those in the control group (P<0.05) while the PaCO2 was significantly lower (P<0.05). Concurrently, the intervention group exhibited significantly lower NRS comfort score compared to the control group [(2.35±1.02) points vs. (3.92±1.45) points] (P<0.05), and also showed significantly higher medication compliance rate and family nursing satisfaction than the control group (97.30% vs. 81.08%, 97.30% vs. 83.78%) (P<0.05). Conclusion High-quality nursing based on Noddings’ caring theory can effectively promote the clinical symptom relief in children with pneumonia, improve blood gas indicators, enhance the treatment comfort and compliance, and significantly enhance the family members’ satisfaction with nursing work.