Objective To observe the clinical efficacy of L?viselle? combined with tranexamic acid in the treatment of melasma. Methods A total of 18 patients with melasma admitted to Department of Dermatology, Ningbo Yinzhou Weilin Medical Beauty Hospital from August to December 2021 were divided into observation group and control group, with 9 cases in each group by randan number toble method. The observation group was treated with tranexamic acid combined with L?viselle? injection, and the control group was treated with tranexamic acid. The area and severity of chloasma, clinical efficacy and adverse reactions were compared between the two groups after treatment. Results The MASI scores of the two groups after treatment were lower than those before treatment, and those in the observation group were lower than those in the control group, the difference was statistically significant (P <0.05). The effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (P <0.05). There were no adverse reactions such as dry skin peeling, unevenness, erythema and bruising, pigmentation, pigment loss, subcutaneous hemorrhage, rash, blisters, granulation or nodules, and infection in both groups after treatment. In the observation group, 2 cases had skin redness and fever after the first treatment, and the symptoms disappeared within 3 days. There were 3 cases of gastrointestinal discomfort in the control group, and the adverse reactions disappeared after taking the medicine after meals. Conclusion L?viselle? combined with tranexamic acid has achieved satisfactory clinical results in the treatment of melasma, which can effectively improve the aesthetic problems of patients' faces, improve the total effective rate of treatment and patients' satisfaction. It is worthy of clinical application.