Objective To analyze the effect of layered energy output mode of high-frequency microneedle on skin physiological indicators in patients with facial rejuvenation. Methods A total of 30 patients with facial rejuvenation admitted to Shenzhen Xiangmi Beau Care Medical Beauty Clinic from November 2022 to November 2023 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 15 patients in each group. The control group was treated with Peninsula 5th generation high-frequency microneedle, and the study group was treated with layered energy output mode of high-frequency microneedle. The overall facial improvement effect, skin physiological indicators, mid-lower facial lifting degree, pain degre and satisfaction were compared between the two groups. Results The total effective rate oftreatment in the study group (100.00%) was higher than that in the control group (66.67%) (P <0.05). After treatment, the transepidermal water loss in the study group was lower than that in the control group, and the stratum corneum hydration and skin elasticity were higher than those in the control group (P <0.05). The mid-lower facial lifting degree of the study group after treatment was higher than that of the control group (P <0.05). The pain degree score of the study group after treatment was lower than that of the control group (P <0.05). The treatment satisfaction of the study group (93.33%) was higher than that of the control group (60.00%) (P <0.05). Conclusion The layered energy output mode of high-frequency microneedle radiofrequency in facial rejuvenation treatment can effectively improve skin physiological indicators, enhance aesthetics, and provide ideal mid-lower facial lifting, yielding high patient satisfaction. It is worthy of clinical application.