To explore the application value of botulinum toxin injection in clinical facial beauty. Methods A total of 90 patients with facial beauty admitted to Tengzhou Central People's Hospital from May 2022 to February 2023 were selected as the research objects. They were randomly divided into control group and observation group, with 45 patients in each group. The control group was treated with microneedle introduction of platelet-rich plasma, and the observation group was injected with botulinum toxin on the basis of the control group. The clinical efficacy, skin status, adverse reactions and cosmetic satisfaction were compared between the two groups. Results The total effective rate of the observation group was 95.56%, which was higher than 80.00% of the control group, and the difference was statistically significant (P <0.05). After treatment, the scores of moisturizing and elasticity in the observation group were higher than those in the control group, and the scores of grease and stripes were lower than those in the control group, the differences were statistically significant (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P >0.05). The cosmetic satisfaction of the observation group was 93.33 %, which was higher than 77.78 % of the control group (P <0.05). Conclusion The injection of botulinum toxin can effectively improve the cosmetic effect in patients with clinical facial beauty, improve the skin condition such as skin moisture, elasticity, oil and spots, with less adverse reactions and higher patient satisfaction.