Objective To analyze the effect of plum-blossom needle-mediated minoxidil delivery combined with low-level laser therapy (LLLT) on hair improvement in patients with seborrheic alopecia. Methods A total of 64 patients with seborrheic alopecia admitted to Yuebei People's Hospital from January to June 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 32 patients in each group. The control group received plum-blossom needle-mediated minoxidil delivery, and the study group received plum-blossom needle-mediated minoxidil delivery combined with LLLT. The hair improvement, scalp symptom scores and adverse reactions were compared between the two groups. Results There were no statistically significant differences in hair diameter and hair density between the two groups at the 12th week of treatment (P >0.05). The hair diameter and hair density of the study group at the 24th and 48th weeks of treatment were higher than those of the control group (P <0.05). The sebum secretion score of the study group at the 24th week of treatment was lower than that of the control group (P <0.05). The scores of erythema and scales in the study group at the 48th week of treatment were lower than those in the control group (P <0.05). There were no statistically significant differences in the incidence of mild pruritus, transient erythema, contact dermatitis, hirsutism or total adverse reactions between the two groups (P >0.05). Conclusion Plum-blossom needle-mediated minoxidil delivery combined with LLLT exerts a synergistic enhancement of therapeutic efficacy. It can effectively promote hair growth, improve the scalp environment, and does not increase the incidence of adverse reactions.