Abstract：Objective：To observe the effect of Chinese medicine five- element music therapy on delirium and negative emotions of patients with severe pneumonia in intensive care unit(ICU). Methods：A total of 86 cases of patients with severe pneumonia who met the inclusion criteria were randomly divided into two groups，with 43 cases in each group. The control group was given routine nursing， and the observation group was additionally given Chinese medicine five- element music therapy based on the treatment of the control group. Nursing comfort rates as well as the incidence rates，types，occurrence time and duration of delirium were observed and compared between the two groups. Before and after intervention，scores of Self-rating Anxiety Scale(SAS)，Self-rating Depression Scale(SDS) and Richards Campbell Sleep Questionnaire(RCSQ) were compared between the two groups. Results：There were seven cases of delirium in the observation group and 16 cases in the control group，and the incidence was 16.28% in the observation group，lower than that of 37.21% in the control group， differences being significant(P＜0.05). The duration of delirium in the observation group was shorter than that in the control group， differences being significant(P＜0.05). There was no significant difference being found in the comparison of occurrence time of delirium between the two groups(P＞0.05). After intervention，scores of SAS，SDS and RSCQ in the two groups were decreased when compared with those before intervention，and the scores in the observation group were lower than those in the control group， differences being significant(P＜0.05). After intervention， scores of physiological dimension，psychological dimension，mental dimension，social and environmental dimension as well as the total score in Kolcaba scale in the observation group were lower than those in the control group， differences being significant(P＜0.05). Conclusion： Chinese medicine five- element music therapy can reduce the incidence of delirium of patients with severe pneumonia undergoing mechanical ventilation in ICU， and improve their sleep quality， negative emotions and nursing comfort.