Objective To explore the effect of group psychodrama intervention on improving sleep quality and negative automatic thoughts in female patients with mild to moderate depression. Methods A total of 72 female patients with mild to moderate depression were randomly assigned to one of two groups, with 36 in each group.The control group received conventional treatment and nursing care, while the observation group additionally received group psychodrama intervention.Before and 1 month after the intervention, both groups were evaluated using the Pittsburgh Sleep Quality Index and the Automatic Thoughts Questionnaire. Results Thirty-four patients in each group completed the study.After the intervention, the observation group had significantly lower scores for depression, sleep quality index, and automatic thoughts than the control group （all P＜0.05）. Conclusion Group psychodrama intervention can effectively ameliorate depressive symptoms, improve sleep quality, and reduce negative automatic thoughts in female patients with mild to moderate depression.