Objective To explore the value of multi-layer aesthetic restoration with composite resin for carious anterior teeth. Methods A total of 60 patients with carious anterior teeth admitted to Dental Clinic of Shaanxi Tusikang Medical Management Co., Ltd. from January 2023 to January 2024 were selected as the research subjects. According to the random number table method, they were divided into the control group and the observation group, with 30 patients in each group. The control group was given ordinary resin filling, and the observation group was given multi-layer aesthetic restoration with composite resin. The dental appearance restoration effect, dental function, adverse reactions and treatment satisfaction were compared between the two groups. Results The scores of shape, marginal adaptation, smooth texture, moderate color, no marginal staining and overall effect in the observation group were higher than those in the control group (P<0.05). The scores of gingival condition, fixed position, masticatory ability, no secondary disease, no residue and overall effect in the observation group were higher than those in the control group (P<0.05). The incidence of adverse reactions in the observation group (3.33%) was lower than that in the control group (23.33%) (P<0.05). The satisfaction rate of the observation group (96.67%) was higher than that of the control group (76.67%) (P<0.05). Conclusion The application of multi-layer aesthetic restoration with composite resin in the treatment of carious anterior teeth has a good effect, which can improve the dental appearance restoration effect, promote the recovery of dental function, reduce the incidence of adverse reactions, and improve patients' treatment satisfaction.