Objective To explore the clinical aesthetic effect of cosmetic intensive pulsed laser in the treatment of facial chloasma. Methods A total of 80 patients with chloasma admitted to the Department of Dermatology, Mengyin County People's Hospital from January to December 2023 were selected and divided into control group and observation group according to different treatment methods, with 40 patients in each group. The control group was treated with conventional drugs, and the observation group was treated with intensive pulsed laser. The clinical efficacy, severity of chloasma, quality of life, occurrence of adverse reactions and subjective satisfaction were compared between the two groups. Results The total effective rate of treatment in the observation group was 95.00%, which was higher than 67.50% in the control group (P <0.05). After 1 and 3 months of treatment, the PGA score and MASI score of the observation group were lower than those of the control group (P <0.05). The DLQI score and MelasQOL score in the observation group were lower than those in the control group after 3 months of treatment (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P >0.05). The subjective satisfaction of the observation group was 95.00%, which was higher than 70.00% of the control group (P <0.05). Conclusion The effect of intensive pulsed laser treatment on patients with facial chloasma is ideal, which can improve the symptoms of chloasma, improve the overall treatment effect, and effectively improve the quality of life of patients with chloasma without increasing adverse reactions. Meanwhile, patients are more satisfied with the treatment effect.