Objective To investigate the effect of small incision apocrine gland excision under tumescent anesthesia on DLQI and HDSS scores in patients with axillary bromhidrosis. Methods A total of 103 patients with axillary bromhidrosis admitted to our hospital from October 2019 to November 2024 were selected as the research subjects, and they were divided into the control group (51 patients) and the study group (52 patients) by the random number table method. The control group was treated with traditional skin spindle excision, and the study group was treated with small incision apocrine gland excision under tumescent anesthesia. The total surgical effective rate, Dermatology Life Quality Index (DLQI) score, Hyperhidrosis Disease Severity Scale (HDSS) score, complication rate and postoperative indicators were compared between the two groups. Results Compared with the total effective rate of 84.31% in the control group, the total effective rate of the study group was higher, reaching 98.08% (P <0.05). Compared with the control group, the DLQI score and HDS S score of the study group after treatment were lower (P <0.05). Compared with 15.69% of the incidence of complications in the control group, the incidence of complications in the study group was lower, only 1.92% (P <0.05). Compared with the control group, the postoperative suture removal time and postoperative recovery time of the study group were shorter (P <0.05). Conclusion The application of small incision apocrine gland excision under tumescent anesthesia in patients with axillary bromhidrosis can improve clinical efficacy and safety, optimize postoperative indicators, reduce disease severity, and enhance the quality of life of patients.