Objective To study the effect of ultra-reduced tension suture combined with superficial radiotherapy on scar score and quality of life in patients with anterior chest keloid. Methods A total of 60 patients with anterior chest keloid admitted to Tengzhou Central People's Hospital from January 2022 to January 2025 were divided into the control group (30 patients) and the observation group (30 patients) by the random number table method. The control group received superficial radiotherapy combined with traditional suture, and the observation group received superficial radiotherapy combined with ultra-reduced tension suture. The scar scores, total effective rate of treatment, negative emotion scores and quality of life scores were compared between the two groups. Results After treatment, the scores of color, blood vessel distribution, thickness and softness in the observation group were lower than those in the control group (P <0.05). The total effective rate of treatment in the observation group was 96.67%, which was higher than 73.33% in the control group (P <0.05). At 1 month after treatment, the anxiety score (40.32±2.52)scores and depression score (43.25±3.79)scores in the observation group were lower than (46.79±3.75)scores and (49.68±4.73)scores in the control group (P <0.05). The scores of all dimensions of quality of life in the observation group after treatment were higher than those in the control group (P <0.05). Conclusion Ultra-reduced tension suture combined with superficial radiotherapy can improve the clinical efficacy and quality of life in patients with anterior chest keloid, alleviate negative emotions and reduce the severity of scars.