Objective To analyze the clinical effect and safety of methylene blue combined with 800 nm semiconductor laser in the treatment of axillary bromhidrosis. Methods The clinical data of 58 patients with axillary bromhidrosis admitted to our hospital from June 2023 to September 2024 were retrospectively analyzed. According to different treatment methods, they were divided into the control group and the observation group, with 29 patients in each group. The control group was treated with 800 nm semiconductor laser, and the observation group was treated with subcutaneous injection of methylene blue combined with 800 nm semiconductor laser. The clinical efficacy, adverse reactions and quality of life were compared between the two groups. Results The total effective rate of treatment in the observation group (96.55%) was higher than that in the control group (79.31%), and the difference was statistically significant (P <0.05). The incidence of adverse reactions in the observation group (27.59%) was higher than that in the control group (17.24%), but the difference was not statistically significant (P >0.05). The DLQI score of the observation group at 6 months after treatment was lower than that of the control group, and the difference was statistically significant (P <0.05). Conclusion Methylene blue combined with 800 nm semiconductor laser in the treatment of axillary bromhidrosis is effective and practical, which can effectively improve the quality of life of patients, and provides a safe, rapid and effective treatment option for axillary bromhidrosis patients.