Objective To explore the application of accountability nursing in children with encephalitis and its effects on treatment compliance. Methods A total of 124 children patients with encephalitis admitted to our hospital from January 2015 to December 2016 were selected for the study and randomly divided into accountability group and control group according to the order of admission, with 62 cases in each group. Control group was given routine nursing intervention, and accountability group was given accountability nursing intervention on this basis. After 3 d of intervention, the treatment compliance, symptoms regression times and hospital stay were compared between the two groups. Results After 3 d of intervention, the effective rate and compliance rate of treatment in accountability group were significantly higher than those in control group (all P<0.05). Th symptoms regression times and hospital stay in accountability group were shorter than those in control group (all P<0.05). Conclusion Accountability nursing can effectively improve the treatment compliance of children patients with encephalitis, and it has ideal treatment effects and prognosis effects after nursing intervention.