Objective To explore the efficacy and safety of sodium hyaluronate (HA) compound solution combined with type A botulinum toxin in the treatment of facial wrinkles. Methods A total of 80 patients with facial wrinkles admitted to the Department of Dermatology, Beijing Ximei Medical Beauty Clinic from January 2023 to February 2024 were included. According to different treatment methods, they were divided into the control group and the observation group, with 40 patients in each group. The control group was treated with type A botulinum toxin, and the observation group was combined with HA compound solution on the basis of the control group. The treatment effect, facial contour index, facial aesthetic satisfaction and adverse reactions were compared between the two groups. Results The total effective rate of treatment in the observation group was 97.50%, which was higher than 82.50% in the control group (P <0.05). The ∠AOB in the observation group after operation was smaller than that in the control group (P <0.05). The facial aesthetic satisfaction score in the observation group was higher than that in the control group (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion The combined application of HA compound solution and type A botulinum toxin has a good effect in the treatment of facial wrinkles. It can improve the facial contour, enhance the patients' facial aesthetic satisfaction, and does not increase the risk of adverse reactions.