To summarize the pulmonary rehabilitation nursing experience of a patient with extremely severe obesity and pulmonary embolism. The patient presented with multiple challenges，including extreme obesity，rapid disease progression，and difficulties with endotracheal intubation and extubation. A comprehensive approach was adopted to address these issues，which included the establishment of a multidisciplinary team，active management of the underlying disease，progressive resistance training，a personalized nutritional plan，and continuous psychological support. On day 18，the patient successfully underwent extubation，having lost 30 kg during hospitalization. The patient’s nutritional status was well-maintained，and improvements in physical endurance were noted. The patient was discharged on day 31 following recovery，and the follow-up of two months confirmed satisfactory recovery.