Objective To compare the differences in the efficacy of manual injection and microneedle introduction of recombinant humanized type Ⅲ collagen in the treatment of periorbital fine lines. Methods A total of 40 patients with periorbital fine lines treated at Beijing Liyang Medical Cosmetology Clinic from June 2023 to June 2024 were selected as the research subjects. According to the random number table method, they were divided into the control group and the experimental group, with 20 patients in each group. The control group was treated with microneedle introduction of recombinant humanized type Ⅲ collagen, and the experimental group was treated with manual injection of recombinant humanized type Ⅲ collagen. The clinical efficacy, skin aging, treatment satisfaction and adverse reactions were compared between the two groups. Results The Fitzpatrick scores of the experimental group at T1 and T2 were better than those of the control group (P <0.05), and there was no significant difference in the Fitzpatrick scores between the two groups at T3 (P >0.05). The VISIA scores of the experimental group at T1, T2 and T3 were lower than those of the control group (P <0.05). The treatment satisfaction of the experimental group (90.00%) was higher than that of the control group (85.00%) (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion Manual injection of recombinant humanized type Ⅲ collagen is more effective than microneedle introduction in the treatment of periorbital fine lines. It can effectively reduce fine lines, improve skin firmness, ameliorate skin aging, and achieve higher patient satisfaction without increasing the risk of adverse reactions.