Objective To analyze the application effect of exosome-rich collagen facial injection in facial anti-aging. Methods From February 2023 to February 2024, 100 patients with facial aging improvement admitted to Shanghai Zheshi Clinic were selected as the research subjects. They were divided into control group and observation group by the random number table method, with 50 patients in each group. The control group was treated with laser, and the observation group was treated with exosome-rich collagen facial injection combined with laser. The treatment effect, skin score, wrinkle severity and atisfaction were compared between the two groups. Results The total effective rate in the observation group was 98.00%, which was higher than 82.00% in the control group (P <0.05). After treatment, the scores of skin elasticity and skin moisture in the two groups were higher than those before treatment, and those in the observation group were higher than those in the control group (P <0.05). After treatment, the scores of skin dark spots and skin pores in the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group (P <0.05). The severity of wrinkles in the two groups after treatment was lower than that before treatment, and that in the observation group was lower than that in the control group (P <0.05). The satisfaction of the observation group was higher than that of the control group (P <0.05). Conclusion Exosome-rich collagen facial injection has a good application effect in facial anti-aging, which can effectively improve the skin condition of patients and reduce wrinkle severity. It has a good anti-aging effect and high patient satisfaction.