Objective To investigate the clinical effect of carbon dioxide laser combined with peninsula gold microneedle in the treatment of striae gravidarum. Methods A total of 60 pregnant women with striae gravidarum admitted to Changsha Huahan Medical Cosmetology Hospital from November 2022 to February 2024 were selected as the research objects. According to the random number table method, they were divided into control group and study group, with 300 pregnant women in each group. The control group was treated with peninsula gold microneedle, and the study group was treated with carbon dioxide laser on the basis of the control group. The repair effect, striae gravidarum, abdominal aesthetics and adverse reactions were compared between the two groups. Results The total effective rate of treatment in the study group was 96.67%, which was higher than 73.33% in the control group (P<0.05). After treatment, the scores of gray value, depression volume, roughness and average depression degree of striae gravidarum in the two groups were lower than those before treatment, and those in the study group were lower than those in the control group (P<0.05). After treatment, the scores of abdominal aesthetics in the two groups were lower than those before treatment, and those in the study group were lower than those in the control group (P<0.05). The incidence of adverse reactions in the study group was lower than that in the control group (P<0.05). Conclusion Carbon dioxide laser combined with peninsula gold microneedle has a definite clinical effect in the treatment of pregnant women with striae gravidarum, which can improve the repair effect of striae gravidarum, reduce the severity of striae gravidarum, improve the abdominal aesthetics of pregnant women, and has high safety.