Objective To explore the effect of skin grafting surgery combined with scar plastic surgery on aesthetic effect in burn patients. Methods A total of 40 patients with deep burns admitted to Zaozhuang Municipal Hospital from January 2021 to December 2023 were selected, and they were divided into the control group and the observation group according to the random number table method, with 20 patients in each group. The control group was treated with single skin grafting surgery, and the observation group was treated with skin grafting surgery combined with scar plastic surgery. The rate of secondary surgery and the survival rate of skin grafts, scar condition and satisfaction were compared between the two groups. Results The rate of secondary surgery in the observation group was 0, which was lower than 25.00% in the control group, and the survival rate of skin grafts was 95.00%, which was higher than 70.00% in the control group (P <0.05). The scores of thickness, color, blood vessel distribution and softness in the observation group after surgery were all lower than those in the control group (P <0.05). The total satisfaction rate in the observation group was 95.00%, which was higher than 70.00% in the control group (P <0.05). Conclusion Skin grafting surgery combined with scar plastic surgery can not only reduce the need for secondary surgery and improve the survival rate of skin grafts, but also improve the scar condition and enhance patients’ satisfaction.