Objective To compare the effect of cast porcelain laminate veneer and ultra-thin porcelain laminate veneer in the aesthetic restoration of anterior teeth. Methods A total of 48 patients who underwent aesthetic restoration of anterior teeth in our hospital from June 1, 2022 to May 31, 2023 were randomly divided into group A (n =24, 41 teeth) and group B (n =24, 29 teeth). Group A was treated with cast porcelain laminate veneer repair, and group B was treated with ultra-thin porcelain laminate veneer repair. The periodontal health status, repair satisfaction and adverse reactions were compared between the two groups. Results After treatment, PLI and SBI in group B were higher than those in group A, while GI and PD were lower than those in group A (P <0.05). There was no significant difference in the repair satisfaction score between the two groups (P >0.05). The incidence of adverse reactions in group A was 6.90%, which was lower than 34.15% in group B (P <0.05). Conclusion Both cast porcelain laminate veneer and ultra-thin porcelain laminate veneer have shown good repair effects in the aesthetic restoration of anterior teeth, and the repair satisfaction is high. However, the incidence of adverse reaction is lower and the safety is higher after ultra-thin porcelain veneer repair.