Objective To explore the repair effect of medical scar repair gel on hypertrophic scars caused by trauma or surgery in children. Methods A total of 120 children with hypertrophic scars caused by trauma or surgery admitted to Chongzuo People's Hospital from June 2022 to June 2024 were selected as the research subjects. According to different treatment regimens, they were divided into the control group and the observation group, with 60 children in each group. The control group received conventional silicone gel combined with elastic sleeve compression therapy, and the observation group received medical scar repair gel combined with elastic sleeve compression therapy. The scar severity, symptom improvement, skin function recovery and adverse reactions were compared between the two groups. Results At 3 and 6 months after treatment, the scores of VSS in the observation group were lower than those in the control group (P<0.05). At 6 months after treatment, the scar thickness, hardness and pigmentation score in the observation group were lower than those in the control group (P<0.05). At 6 months after treatment, the VAS scores of pruritus and pain in the observation group were lower than those in the control group, while the improvement rates of pruritus and pain in the observation group were higher than those in the control group (P<0.05). At 6 months after treatment, the skin elasticity recovery rate of the observation group was (78.54±9.28)%, which was higher than (68.17±10.45)% of the control group (P<0.05). There was no statistically signiffcant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Medical scar repair gel has a deffnite therapeutic effect in the treatment of children with hypertrophic scars caused by trauma or surgery. It can effectively promote scar softening, improve scar appearance, alleviate pruritus and pain symptoms, accelerate the transformation of scar tissue to normal skin, and has favorable safety.