UNLABELLED: Objective This study aimed to analyse the effect of music therapy combined with graded rehabilitation exercise on postoperative patients with ankle fractures. METHODS: This retrospective study was conducted on 100 patients with ankle fractures, all of whom were admitted to Nanjing First Hospital between January 2019 and December 2021. Patients were treated with open reduction and internal fixation. According to whether the patients received music therapy or not, they were grouped into the music therapy group and the conventional group, each comprising 50 cases. The recovery time, rehabilitation efficacy, ankle range of motion (ROM), pain level (Numerical Rating Scale [NRS]) and quality of life (World Health Organization Quality of Life Evaluation Questionnaire [WHOQOL-BREF]) were compared between the two groups. RESULTS: The postoperative ambulation time, fracture healing time, hospital stay and total effective rate showed no significant difference between the two groups (P > 0.05). Two months after surgery, the plantarflexion, dorsiflexion, inversion and eversion range of the two groups significantly increased compared with that before the intervention, but the ankle ROM showed no significant difference between the two groups (P > 0.05). The NRS scores of the music therapy group at 7, 14 and 28 days after surgery were significantly lower than those of the conventional group (P < 0.05). Furthermore, the WHOQOL-BREF scores of psychological function, physical function, social function and material life dimensions in the music therapy group were significantly higher than those in the conventional group (P < 0.05). CONCLUSIONS: Music therapy combined with graded rehabilitation exercise can reduce postoperative pain in patients with ankle fractures and improve their quality of life.