Objective To explore the efficacy and safety of gold microneedle combined with platelet-rich plasma in the treatment of atrophic acne scar. Methods A total of 50 patients with atrophic acne scar admitted to Beijing Laserking BeauCare Medical Cosmetic Clinic from June 2022 to June 2024 were selected as the research subjects, and they were divided into conventional group and experimental group according to the random number table method, with 25 patients in each group. The conventional group was treated with gold microneedle, and the experimental group was treated with platelet-rich plasma on the basis of the conventional group. The clinical efficacy, adverse reactions and repair aesthetics satisfaction were compared between the two groups. Results The total effective rate of treatment in the experimental group was 96.00%, which was higher than 72.00% in the conventional group, and the difference was statistically significant (P <0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P >0.05). The repair aesthetics satisfaction in the experimental group was 96.00%, which was higher than 68.00% in the conventional group, and the differenc e was statistically significant (P <0.05). Conclusion The clinical efficacy of gold microneedle combined with platelet-rich plasma in the treatment of atrophic acne scar is accurate, and the overall treatment effect is excellent, safe and reliable, which can satisfy patients' requirements for aesthetics. It is worthy of clinical application.