Objective To explore the effect of comprehensive nursing based on theory of goal attainment in ultra-pulsed carbon dioxide fractional laser treatment for patients with facial acne scar. Methods A total of 116 patients with facial acne scar admitted to Tai'an 88th Hospital from January to June 2024 were selected, and they were divided into the control group (n =58) and the study group (n =58) by the random number table method. The control group received conventional nursing, and the study group received comprehensive nursing based on theory of goal attainment. The skin recovery time, acne scar improvement, negative emotions and satisfaction were compared between the two groups. Results The pain duration, scab detachment time and erythema duration in the study group were shorter than those in the control group (P <0.05). The scores of various items of acne scar improvement in the study group after nursing were lower than those in the control group (P <0.05). The scores of SAS and SDS in the study group after nursing were lower than those in the control group (P <0.05). The satisfaction rate in the study group (98.28%) was higher than that in the control group (86.21%) (P <0.05). Conclusion The application effect of comprehensive nursing based on theory of goal attainment in ultra-pulsed carbon dioxide fractional laser treatment for patients with facial acne scar is definite. It can meet the nursing needs of patients, effectively regulate their negative emotions, help to shorten skin recovery time, and has positive significance for promoting the improvement of acne scar.