Objective To explore the effect of high-frequency fractional microneedle technology in periorbital rejuvenation treatment. Methods A total of 50 patients who received periorbital rejuvenation treatment in the Department of Dermatology, Shanghai Rose Medical Beauty Hospital from January to October 2024 were selected as the research subjects. According to the random number table method, they were divided into the control group and the study group, with 25 patients in each group. The control group was treated with conventional carbon dioxide laser, and the study group was treated with high-frequency fractional microneedle technology. The Fitzpatrick wrinkle score, periorbital skin elasticity, skin moisture, Global Aesthetic Improvement Scale (GAIS) score, satisfaction and adverse reaction rate were compared between the two groups. Results The Fitzpatrick wrinkle scores of the study group at 1 week, 1 month and 3 months after treatment were lower than those of the control group (P <0.05). The skin elasticity and skin moisture of the study group after treatment were better than those of the control group (P <0.05). The GAIS score of the study group after treatment was lower than that of the control group (P <0.05). The satisfaction rate of the study group (100.00%) was higher than that of the control group (72.00%) (P <0.05). The incidence of adverse reactions in the study group (4.00%) was lower than that in the control group (28.00%) (P <0.05). Conclusion The application of high-frequency fractional microneedle technology in periorbital rejuvenation treatment can effectively improve periorbital skin wrinkles, enhance skin elasticity and moisture, which is beneficial for improving patient satisfaction, with mild adverse reactions and definite overall aesthetic effect.