Objective To explore the preliminary application effect of the artificial intelligence training system for clinical nursing decision-making thinking in acute left heart failure for the training of newly recruited nurses. Methods Based on the pathogenesis of acute left heart failure，cases of acute left heart failure with different etiologies were designed，and case dialogue scripts based on standardized patients were drafted. By using artificial intelligence natural language processing technology，virtual simulation scenarios for acute left heart failure nursing were created. An artificial intelligence training system for nursing decision-making thinking was finally developed，which includes four modules：personal information，case training，assessment and evaluation，and system management. In May 2025，the system was applied to 173 newly recruited nurses in the hospital. Results A total of 411 training data were generated from 173 newly recruited nurses. The score of newly recruited nurses in clinical nursing decision-making thinking for acute left heart failure was（70.99±8.63） points，with an overall decision-making accuracy rate of 73.53%. The total response time for each training session was 794.96 s[interquartile range（IQR）=777.11]，and the response time for decision point was 29.44 s（IQR=28.78）. Conclusion The artificial intelligence training system for clinical nursing decision-making thinking in acute left heart failure is usable. It is helpful in stimulating the learning enthusiasm of newly recruited nurses，and identifying their weaknesses in clinical nursing decision-making thinking for acute left heart failure.