Objective To explore the effect of traditional Chinese medicine Wentong method combined with 308 nm excimer laser in the treatment of alopecia areata. Methods From January 2023 to January 2024, 69 patients with alopecia areata admitted to the First Hospital of Qiqihar were collected. According to different treatment methods, they were divided into fire needle combined with 308 nm excimer laser group (group A), fire needle group (group B), 308 nm excimer laser group (group C), with 23 patients in each group. The clinical efficacy, final hair density, hair loss symptom improvement score, skin disease quality of life index score and incidence of adverse reactions were compared among the three groups. Results The total effective rate of group A was higher than that of group B and group C (P <0.05). After treatment, the final hair density of group A was higher than that of group B and group C (P <0.05). The improvement score of alopecia symptoms in group A was higher than that in group B and group C, and the score of skin disease quality of life index was lower than that in group B and group C (P <0.05). There was no significant difference in the incidence of adverse reactions among the three groups (P >0.05). Conclusion Wentong therapy of traditional Chinese medicine combined with 308 nm excimer laser is effective in the treatment of alopecia areata, which can increase the density of terminal hair, improve the symptoms of alopecia, improve the quality of life of patients, and has high safety.