To explore the clinical effect of sodium hyaluronate compound solution in the treatment of neck horizontal wrinkles. Methods A total of 50 female patients with neck wrinkles treated in Jiaxing Shuguang Medical Beauty Hospital from April 2021 to April 2022 were selected as the research objects. According to the treatment methods, they were divided into control group (n =24) and observation group (n =26). The control group was treated with hyaluronic acid gel, and the observation group was treated with sodium hyaluronate compound solution. The clinical efficacy, satisfaction and adverse reactions were compared between the two groups. Results The WAS score of the of the two groups after treatment was lower than that before treatment, and that of the observation group was lower than that of the control group, and the difference was statistically significant (P ＜0.05). The satisfaction rate of the observation group was 88.46%, which was higher than 62.50% of the control group, and the difference was statistically significant (P ＜0.05). The incidence of adverse reactions in the observation group was 7.69%, which was lower than 37.50% in the control group, and the difference was statistically significant (P ＜0.05). Conclusion Sodium hyaluronate compound solution is effective and safe in the treatment of neck wrinkles, which can improve patient satisfaction.