Objective To explore the effect of fractional CO2 laser cosmetic technology in the treatment of pigmented nevus on patients' quality of life. Methods A total of 100 patients with pigmented nevus admitted to Shanghai Nothia Medical Cosmetology Hospital from June 2021 to June 2023 were selected as the research subjects, and they were divided into the control group and the observation group by the random number table method, with 50 patients in each group. The control group was treated with minimally invasive excision, and the observation group was treated with fractional CO2 laser cosmetic technology. The clinical efficacy, wound healing time, pain level, adverse reaction rate and quality of life were compared between the two groups. Results Compared with the control group, the scores of social function, role function, physical function and cognitive function in the observation group after intervention were higher (P <0.05). Compared with the total effective rate of treatment in the control group (82.00%), the total effective rate of treatment in the observation group (98.00%) was higher (P <0.05). Compared with the control group, the wound healing time of the observation group was shorter, and the VAS score was lower (P <0.05). Compared with the incidence of adverse reactions in the control group (16.00%), the incidence of adverse reactions in the observation group (2.00%) was lower (P <0.05). Conclusion The application of fractional CO2 laser cosmetic intervention in the treatment of pigmented nevus can effectively improve patients' clinical symptoms, promote wound healing, reduce pain level and improve patients' quality of life.