Objective To explore the clinical effect of microneedle radiofrequency combined with red and blue light in the treatment of mild to moderate acne. Methods A total of 238 patients with mild to moderate acne admitted to Chongqing Hospital of Traditional Chinese Medicine from August to September 2022 were randomly divided into observation group (n=128) and control group (n=110). The observation group was treated with microneedle radiofrequency combined with red and blue light irradiation, while the control group was treated with simple red and blue light irradiation. The severity of acne, clinical efcacy, quality of life and adverse reactions were compared between the two groups. Results After treatment, the total scores of GAGS in the two groups were lower than those before treatment (P<0.05), and the total scores of GAGS in the observation group were lower than those in the control group after 1, 2, 3 and 4 times of treatment (P<0.05). The total e?ective rate of treatment in the observation group (96.86%) was lower than that in the control group (87.27%) (P<0.05). After treatment, the total score of Acne-QOL in the two groups was higher than that before treatment, and that in the observation group was higher than the control group (P<0.05). There was no signifcant di?erence in the incidence of adverse reactions between the observation group (43.75%) and the control group (40.00%) (P>0.05). Conclusion Microneedle radiofrequency combined with red and blue light in the treatment of mild to moderate acne has fast onset, good e?ect and high safety, and can e?ectively improve the quality of life of patients.