Objective To analyze the effect of intense pulsed light on improving skin aging and its influence on patient satisfaction. Methods A total of 90 patients with skin aging admitted to the Department of Dermatology, Suining Municipal Hospital of TCM from September 2023 to September 2024 were selected as the research subjects, and they were divided into the pigmentation group, skin laxity group, and telangiectasia group according to their symptoms, with 30 patients in each group. All patients received intense pulsed light treatment. The treatment effect, treatment satisfaction and adverse reactions were compared among the three groups. Results The total effective rate of treatment in the pigmentation group (90.00%) was higher than that in the skin laxity group (66.67%) and the telangiectasia group (10.00%) (P <0.05). The treatment satisfaction of the pigmentation group (93.33%) was higher than that of the skin laxity group (70.00%) and the telangiectasia group (63.33%) (P <0.05). The incidence of adverse reactions in the pigmentation group (6.67%) was lower than that in the skin laxity group (26.67%) and the telangiectasia group (30.00%) (P <0.05). Conclusion Intense pulsed light has a better effect on improving pigmentation, with higher patient satisfaction and lower incidence of adverse reactions.