Abstract: The practical experience of nursing for 1 case of pneumonic plague patient with secondary septic shock, acute respiratory distress syndrome (ARDS) and respiratory failure was summarized. The key points of the nursing included ward management and emergency personnel reserves, individualized and precise nursing of the patient (fever care, prevention and nursing of complications), protective measures, discharge preparation and continuity of care services. The ward disinfection and isolation system was strictly implemented during the nursing process, the standard precautions for health care workers were executed; a tiered protection and emergency response process was established to create a zero-infection prevention barrier. An individualized and precise nursing plan covering life support and complication management was developed based on the patient's dynamic condition. The terminal disinfection, discharge education and guidance for isolation at home were completed. The patient successfully met discharge criteria after 33 days of comprehensive symptomatic treatment and precise nursing care, and no case of hospital-associated cross infection and secondary infection was found. A 6-month follow-up showed that the patient had a favorable recovery of somatic function after the discharge.