Objective To analyze the effect of picosecond laser combined with photorejuvenation in patients with pigmentation after facial burns. Methods A total of 80 patients with pigmentation after facial burns admitted to Juye County Fenghuang Community Health Service Center from December 2022 to October 2024 were selected as the research subjects, and they were divided into the control group and the study group by the random number table method, with 40 patients in each group. The control group was treated with picosecond laser, and the study group was treated with picosecond laser combined with photorejuvenation. The pigmentation improvement, complication rate and treatment satisfaction were compared between the two groups. Results The scores of emotional impact, lesion size, pigment spot number and pigment intensity in the study group at 3 months after intervention were lower than those in the control group (P <0.05). The incidence of complications in the study group was 2.50%, which was lower than 15.00% in the control group (P <0.05). The treatment satisfaction in the study group was 97.50%, which was higher than 82.50% in the control group (P <0.05). Conclusion The application of picosecond laser combined with photorejuvenation in patients with pigmentation after facial burns has a good effect. It can further optimize the improvement of pigmentation, with a lower incidence of post-treatment complications and higher patient satisfaction, which is worthy of clinical application.