To study the therapeutic effect of recombinant bovine basic fibroblast growth factor gel combined with CO2 fractional laser on patients with facial depression scar after acne. Methods A total of 80 patients with facial depressed scar after acne admitted to Wuxi Fifth Hospital Affiliated to Jiangnan University/Wuxi Fifth People's Hospital from March 2019 to March 2022 were selected as the research objects. According to the random number table method, they were divided into reference group and analysis group, with 40 patients in each group. The reference group was treated with CO2 fractional laser, and the analysis group was treated with recombinant bovine basic fibroblast growth factor gel combined with CO2 fractional laser. The clinical effects, clinical indicators (scab formation time, pain time, erythema duration) and incidence of adverse reactions were compared between the two groups. Results The total effective rate of treatment in the analysis group was 95.00%, which was higher than 72.50% in the reference group (P <0.05). The scab time, pain time and erythema duration in the analysis group were shorter than those in the reference group (P <0.05). The incidence of adverse reactions in the analysis group was 2.50%, which was lower than 22.50% in the reference group (P <0.05). Conclusion Recombinant bovine basic fibroblast growth factor gel combined with CO2 fractional laser is effective in the treatment of facial depressed scars after acne, which can shorten the scab formation time, pain time and erythema duration of patients, and has high safety.