Objective To investigate the efficacy and safety of intensive pulsed light (IPL) combined with tacrolimus ointment in the treatment of erythematotelangiectatic rosacea (ETR). Methods A total of 52 patients with ETR admitted to Friendship Plastic Surgery Hospital of Nanjing Medical University from January 2021 to January 2024 were selected and divided into intervention group and control group by random number table method, with 26 patients in each group. The control group was treated with tacrolimus, and the intervention group was treated with tacrolimus+IPL. The clinical efficacy, symptom score, skin dysfunction and adverse reactions were compared between the two groups. Results The total effective rate of treatment in the intervention group was 88.46%, which was higher than 50.00% in the control group (P <0.05). After treatment, the symptom scores of the intervention group were lower than those of the control group (P <0.05). After treatment, the skin erythema index index, transcutaneous water loss index and stratum corneum water content index of the intervention group were better than those of the control group (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion For ETR patients, the application of IPL+tacrolimus ointment can improve the total effective rate, improve the clinical symptoms and skin barrier function of patients, and has high safety.