Introduction: Creative Dance, as an educational approach to physical activity emphasizing autonomous exploration and creative expression, has demonstrated significant benefits for children’s cognitive development and independent learning. This study aimed to examine the effects of Creative Dance on the development of autonomy among Chinese children aged 4 to 6 years, and to investigate the mediating role of autonomy need satisfaction in this process. Methods: A randomized, single-blind, two-arm experimental design was utilized, with classrooms serving as the unit of assignment. A total of 102 children aged 4–6 years were randomly allocated to either an experimental group (Creative Dance) or a control group (DanceSport). The children’s autonomy was measured pre- and post-intervention using parent-proxy reports. In addition, qualitative interviews and video observations were conducted to assess the degree of autonomy need satisfaction experienced by the children during the Creative Dance intervention. Results: Analysis of the pre-intervention data revealed no statistically significant differences in autonomy scores between the experimental and control groups. Post-intervention, the children in the experimental group scored significantly higher across all dimensions of autonomy compared to those in the control group. Mediation analysis indicated that autonomy need satisfaction significantly mediated the effect of Creative Dance on self-assertion, but not on self-reliance or self-control. Discussion: Creative Dance constitutes an effective intervention for supporting autonomy need satisfaction and promoting overall autonomy development in young children. Satisfaction of autonomy needs serves as a key mechanism through which Creative Dance enhances self-assertion. These findings provide empirical evidence supporting the incorporation of Creative Dance into early childhood education as a means of promoting physical and mental development.