Objective To study the effect of hyaluronic acid hydrating injection combined with botulinum toxin microbotox injection on skin condition in patients undergoing facial rejuvenation. Methods A total of 120 patients undergoing facial rejuvenation admitted to our hospital from August 2023 to August 2024 were selected. According to the random number table method, they were divided into the control group and the observation group, with 60 patients in each group. The control group was treated with simple hyaluronic acid hydrating injection, and the observation group was treated with botulinum toxin microbotox injection on the basis of the control group. The skin roughness, skin condition, treatment satisfaction, pain and adverse reactions were compared between the two groups. Results The skin roughness score of the observation group at 2 and 4 weeks after treatment was lower than that of the control group (P <0.05). The skin improvement degree of the observation group after treatment was better than that of the control group (P <0.05). The treatment satisfaction rate of the observation group (96.67%) was higher than that of the control group (73.33%) (P <0.05). There was no significant difference in pain scores and incidence of adverse reactions between the two groups (P >0.05). Conclusion In the treatment of facial rejuvenation, the application of hyaluronic acid hydrating injection combined with botulinum toxin microbotox injection can improve the clinical efficacy and patient satisfaction, effectively improve the skin condition, and the degree of pain and the incidence of adverse reactions are low, which is worthy of clinical application.