Background: Post-traumatic stress disorder (PTSD) due to lung cancer seriously affects the mood state of patients. Intensive cognitive management is a structured management method based on cognitive behavioral therapy, which can correct cognitive distortions and regulate adverse emotions. This study mainly explored the effect of intensive cognitive management on the mood state of patients with PTSD due to lung cancer. Methods: A retrospective analysis was conducted on the clinical data of 169 patients with PTSD due to lung cancer admitted to our hospital from June 2020 to June 2021. Based on different clinical management schemes, these patients were divided into the reference group (RG, n = 87, routine management) and the study group (SG, n = 82, routine management+intensive cognitive management). The sleep status and degree of depression and anxiety were evaluated using the Pittsburgh Sleep Quality Index (PSQI), Self-rating Anxiety Scale (SAS), Depression Scale (D), and Post-traumatic Stress Disorder Check List (PCL). Results: After 2 weeks (T1) and 4 weeks (T2) of nursing, the scores on the PSQI (p < 0.001), SAS (T0-T1: p < 0.001; T0-T2: p < 0.001) and D (T0-T1: p = 0.026, p < 0.001; T0-T2: p < 0.001), as well as three PCL factors (p < 0.001) of the two groups were significantly lower than those before nursing (T0). At the T1 and T2 stages, difference scores for the PSQI (difference score 1: p = 0.003; difference score 2: p = 0.006), SAS (difference score 1: p = 0.002; difference score 2: p = 0.007), and D (difference score 1: p < 0.001; difference score 2: p = 0.002) were higher in the SG compared with the RG. At the T1 stage, the difference score of the PCL high-alert factor (p = 0.008) was higher in the SG compared with the RG, with no significant difference in difference scores of other two factors (p > 0.05). At the T2 stage, the SG had higher difference scores for the three PCL factors compared with the RG (p < 0.001, p = 0.011, p < 0.001). Conclusion:<bold> </bold>Intensive cognitive management can effectively improve sleep quality and adverse emotions and has potential for clinical management of PTSD in patients with lung cancer.