Objective To explore the effect of methylene blue combined with ropivacaine on the analgesic effect after abdominoplasty. Methods A total of 100 patients who underwent abdominoplasty in Guizhou Plastic and Oral Aesthetic Surgery Hospital from February 2022 to December 2023 were selected as the research subjects. According to different analgesic methods, they were divided into the control group and the observation group, with 50 patients in each group. Both groups received general anesthesia with tracheal intubation. The control group received local infiltration of lidocaine, and the observation group received local infiltration of methylene blue combined with ropivacaine. Both groups received patient controlled intravenous analgesia after surgery. The postoperative pain, analgesia acceptance and adverse reactions were compared between the two groups. Results The VAS scores at 6, 24, and 48 hours and 3 and 5 days after surgery in the observation group were all lower than those in the control group (P <0.05). The acceptance of postoperative analgesia in the observation group was 98.00%, which was higher than 80.00% in the control group (P <0.05). The incidence of adverse reactions in the observation group (8.00%) was lower than that in the control group (44.00%) (P <0.05). Conclusion Local infiltration of methylene blue combined with ropivacaine during abdominoplasty can provide safe and effective analgesic effects for patients, with precise anesthetic effect, long analgesic time, and few adverse reactions, which is worthy of clinical application.