Objective To explore the efficacy and safety of hyaluronic acid filling combined with PPDO thread lifting technique in the treatment of facial rejuvenation. Methods A total of 95 patients who underwent facial rejuvenation treatment in Shanghai Yangsi Hospital from September 2020 to October 2024 were selected as the research subjects. According to the random number table method, they were divided into the control group (n =48) and the observation group (n =47). The control group received PPDO thread lifting technique, and the observation group received hyaluronic acid filling combined with PPDO thread lifting technique. The treatment effect, complications, facial contour improvement and satisfaction were compared between the two groups. Results The total effective rate of treatment in the observation group (97.87%) was higher than that in the control group (83.33%) (P <0.05). The incidence of complications in the observation group (0) was lower than that in the control group (20.83%) (P <0.05). The scores of facial wrinkles, mandibular margin morphology and nasolabial fold morphology in the observation group were all lower than those in the control group (P <0.05). The satisfaction score in the observation group was higher than that in the control group (P <0.05). Conclusion The application of hyaluronic acid filling combined with PPDO thread lifting technique in the treatment of facial rejuvenation has a good effect, which can effectively improve issues related to poor facial contour. Additionally, it is beneficial to reducing the incidence of complications, and enhancing the satisfaction of patients, with high efficacy and safety in treatment.