Objective To explore the application of water light injection combined with microneedle radiofrequency in facial rejuvenation. Methods A total of 70 patients with facial skin natural aging admitted to the Affiliated Drum Tower Hospital of Nanjing University Medical School from September 2022 to March 2024 were selected and divided into control group and experimental group by the convenience sampling method, with 35 patients in each group. The control group was intervened with water light injection, and the experimental group was intervened with water light injection combined with microneedle radiofrequency. The clinical efficacy, the degree of facial rejuvenation and the skin characteristics were compared between the two groups. Results The total effective rate of treatment in the experimental group (100.00%) was higher than that in the control group (88.57%) (P <0.05). After treatment, the scores of FWS and WSRS in the two groups were lower than those before treatment, and the scores of FWS and WSRS in the experimental group were lower than those in the control group (P <0.05). The VISIA score in the experimental group was lower than that in the control group at 4, 12 and 24 weeks after treatment (P <0.05). Conclusion The combination of water light injection and microneedle radiofrequency can improve the clinical efficacy of patients with facial skin natural aging, improve the degree of facial rejuvenation and facial skin characteristics, with higher clinical application value.