Objective To explore the clinical effect of PPDO line combined with hyaluronic acid and type A botulinum toxin in the treatment of moderate to severe nasolabial fold. Methods A total of 60 patients with moderate to severe nasolabial fold admitted to Gorgeous Orient Medical Cosmetology Clinic from May 2023 to May 2024 were selected, and they were divided into control group and experimental group by the random number table method, with 30 patients in each group. The control group was treated with single hyaluronic acid, and the experimental group was treated with PPDO line+hyaluronic acid+type A botulinum toxin. The nasolabial fold wrinkle depth change, skin elasticity and tightness, treatment effect satisfaction and complications were compared between the two groups. Results After 1 and 3 months of treatment, the score of nasolabial fold wrinkle depth in the experimental group was lower than that in the control group (P <0.05). After 1 and 3 months of treatment, the R0 value in the experimental group was lower than that in the control group, and the R2 value was higher than that in the control group (P <0.05). The treatment satisfaction rate of the experimental group was higher than that of the control group (P <0.05). There was no significant difference in the incidence of complications between the two groups (P >0.05). Conclusion PPDO line combined with hyaluronic acid and type A botulinum toxin can improve the therapeutic effect of moderate to severe nasolabial fold, and can effectively improve the depth of wrinkles and skin elasticity, with higher patient satisfaction and good safety.