Objective To explore the effect of type A botulinum toxin combined with sodium hyaluronate gel in facial wrinkle removal. Methods A total of 60 patients who underwent facial rhytidectomy in our hospital from January to December 2022 were selected as the research objects. They were divided into control group and observation group by random number table method, with 30 patients in each group. The control group was treated with type A botulinum toxin, and the observation group was treated with type A botulinum toxin combined with sodium hyaluronate gel. The clinical efficacy, quality of life, satisfaction and adverse reactions were compared between the two groups. Results The total effective rate of treatment in the observation group was 100.00%, which was higher than 73.33% in the control group (P <0.05). After treatment, the scores of material life, physical function, psychological function and social function in the observation group were higher than those in the control group (P <0.05). The satisfaction rate of the observation group was 100.00%, which was higher than 73.33% of the control group (P <0.05). The incidence of adverse reactions in the observation group was 6.67%, which was lower than 10.00% in the control group, but the difference was not statistically significant (P >0.05). Conclusion The application of type A botulinum toxin combined with sodium hyaluronate gel in facial wrinkle removal is effective, which can effectively reduce facial wrinkles, improve the quality of life and satisfaction of patients, and the incidence of adverse reactions after treatment is low, and the application safety is high.