With the increasing social demand for minimally invasive cosmetics, technologies in the field of facial rejuvenation and wrinkle removal have been continuously innovated. As a new type of tool combining traditional Chinese medicine acupuncture theory with modern minimally invasive surgery essence, the blade needle has attracted wide attention in this field due to its characteristics of small trauma, fast recovery and precise action level. At present, relevant studies have initially clarified that the blade needle exerts its wrinkle-removing effect through multiple pathways such as releasing fascial adhesion, stimulating collagen regeneration and regulating local microcirculation, and has accumulated practical experience in the clinical intervention of dynamic and static wrinkles. However, in-depth analysis of its mechanism of action, evidence-based evaluation of long-term efficacy, and optimized combination schemes with other mainstream technologies (such as botulinum toxin injection and thread lifting) are still key issues facing the current research. This article aims to systematically sort out the technical principles, operation specifications, efficacy and safety evidence of blade needle wrinkle removal, review its research progress, so as to provide a scientific basis for clinical practice and prospect the future research direction.