Objective To study the effect of immediate plastic repair of trauma soft tissue defects in oral and maxillofacial region. Methods A total of 80 patients with traumatic soft tissue defects in oral and maxillofacial region admitted to our hospital from January 2020 to June 2023 were selected as the research objects. According to the random number table method, they were divided into control group and observation group, with 40 patients in each group. The control group was treated with routine surgery, and the observation group was treated with immediate plastic repair. The operation related indexes, oral function, aesthetics and complications were compared between the two groups. Results The operation time, intraoperative blood loss, anal exhaust time and hospitalization time of the observation group were better than those of the control group (P <0.05). After intervention, the scores of occlusion, oral closure function, mouth opening, language expression and masticatory function in the observation group were higher than those in the control group (P <0.05). After intervention, the scores of scar thickness, compliance, flatness, softness, color and color in the observation group were lower than those in the control group (P <0.05). The incidence of complications in the observation group was 5.00%, which was lower than 20.00% in the control group (P <0.05). Conclusion The effect of immediate plastic repair technique in the treatment of trauma soft tissue defects in oral and maxillofacial region is better, which is beneficial to improve the patient's oral function, improve the postoperative aesthetics, and the incidence of complications is low.