Objective To explore the value of minimally invasive extraction in the treatment of mandibular impacted wisdom teeth extraction, and to analyze its effect on pain and anxiety. Methods A total of 100 patients who underwent mandibular impacted wisdom teeth extraction treatment in the Department of Stomatology of our hospital from April 2023 to January 2024 were selected as the research subjects, and they were randomly divided into reference group and observation group, with 50 patients in each group. The reference group was treated with traditional extraction, and the observation group was treated with minimally invasive extraction. The treatment effect, surgical indexes, pain, anxiety and complications were compared between the two groups. Results The total effective rate of the observation group was 98.00%, which was higher than 86.00% of the reference group (P <0.05). The operation time of the observation group was shorter than that of the reference group, the degree of limited mouth opening was lower than that of the reference group, and the scores of extraction integrity and swelling degree were lower than those of the reference group (P <0.05). After operation, the scores of HAMA and VAS in the observation group were lower than those in the reference group (P <0.05). The incidence of complications in the observation group was 4.00%, which was lower than 16.00% in the reference group (P <0.05). Conclusion The application of minimally invasive extraction in the treatment of mandibular impacted wisdom teeth extraction is more ideal, which can effectively reduce patients' postoperative anxiety and pain. The incidence of postoperative complications is low, and the safety is high, which is worthy of clinical application.