Objective To explore the effect of early plastic repair therapy in patients with burn plastic surgery and its influence on secondary surgery rate. Methods A total of 60 patients with burn plastic surgery admitted to our hospital from May 2022 to May 2024 were selected as the research subjects, and they were divided into reference group and study group by the random drawing lots method, with 30 patients in each group. The reference group was given elective plastic repair, and the study group was given early plastic repair (within 3 days). The clinical efficacy, secondary surgery, psychological status, quality of life and complications were compared between the two groups. Results The total effective rate of clinical treatment in the study group (96.67%) was higher than that in the reference group (73.33%), and the difference was statistically significant (P <0.05). The secondary surgery rate in the study group (0) was lower than that in the reference group (20.00%), and the difference was statistically significant (P <0.05). After treatment, the scores of SAS and SDS in the study group were lower than those in the reference group, and the difference were statistically significant (P <0.05). After treatment, the scores of social relationship, environment, psychology and physiology in the study group were higher than those in the reference group, and the difference were statistically significant (P <0.05). The incidence of complications in the study group (3.33%) was lower than that in the reference group (23.33%), and the difference was statistically significant (P <0.05). Conclusion The treatment effect of early plastic repair therapy for burn patients is better, which can reduce the incidence of complications and the secondary surgery rate, help to alleviate the negative emotions of patients and improve the quality of life. It is worthy of clinical application.