Objective To explore the effect of percutaneous facial artery injection of hyaluronidase on skin recovery in patients with vascular embolism caused by facial cosmetic injection. Methods A total of 60 patients with vascular embolism caused by facial cosmetic injection who received treatment in the Department of Cosmetic Surgery, Shenzhen Number One Meidu Medical Beauty Clinic from March 2022 to December 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 30 patients in each group. The control group was given direct injection of hyaluronidase in the embolized area, and the study group was given percutaneous facial artery injection of hyaluronidase. The treatment onset time, skin recovery, scar retention and adverse reaction rate were compared between the two groups. Results The skin relaxation onset time, injection-site pain relief time, local redness and swelling regression time and ulcerated wound recovery time in the study group were shorter than those in the control group (P <0.05). At 24 hours after treatment, the lesion area in the study group was smaller than that in the control group, the VAS score was lower than that in the control group, and the capillary refill time was shorter than that in the control group (P <0.05). The scores of each dimension of VSS in the study group at 7 days after treatment were lower than those in the control group (P <0.05). The incidence of adverse reactions in the study group (3.33%) was lower than that in the control group (20.00%) (P <0.05). Conclusion Percutaneous facial artery injection of hyaluronidase can effectively treat vascular embolism caused by facial cosmetic injection. It takes effect quickly, which can not only improve the embolism symptoms, restore skin blood flow, but also promote the healing of skin wound, and reduce scar retention, with high safety.