Objective To explore the application effect of skin grafting surgery combined with scar revision in cosmetic reconstruction after burn, and evaluate the influence of this method on patients' quality of life. Methods A total of 100 patients who underwent cosmetic reconstruction after burn in China University of Geosciences (Wuhan) Hospital from October 2020 to June 2023 were selected as the research subjects, and they were divided into conventional group and combined group by the random number table method, with 50 patients in each group. The conventional group was treated with skin grafting surgery, and the combined group was treated with skin grafting surgery combined with scar revision. The scar improvement, skin grafting survival rate, quality of life, treatment satisfaction and complication rate were compared between the two groups. Results After treatment, the scar improvement and skin grafting survival rate in the combined group were better than those in the conventional group (P <0.05). The quality of life score in the combined group after treatment was higher than that in the conventional group (P <0.05). The satisfaction rate of treatment in the combined group was 96.00%, which was higher than 82.00% in the conventional group (P <0.05). The incidence of complications in the combined group was 6.00%, which was lower than 20.00% in the conventional group (P <0.05). Conclusion Skin grafting surgery combined with scar revision in cosmetic reconstruction after burn shows excellent treatment effect, which not only improves patients' scar condition, but also enhances patients' quality of life and treatment satisfaction, and is worthy of clinical appl ication.