Objective To explore the effect of radiofrequency combined with intense pulsed light in the treatment of patients with facial pigmentation complicated with skin aging. Methods A total of 100 patients with facial pigmentation complicated with skin aging who received treatment in the Department of Dermatology, Taiyuan Military Medical Cosmetology Hospital from January 2022 to January 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 50 patients in each group. The control group was treated with intense pulsed light, and the observation group was treated with radiofrequency combined with intense pulsed light. The skin improvement, treatment satisfaction and adverse reactions were compared between the two groups. Results The scores of pigmentation improvement, skin elasticity, ffrmness and skin texture in the observation group after treatment were higher than those in the control group (P<0.05). The treatment satisfaction rate of the observation group (92.00%) was higher than that of the control group (76.00%) (P<0.05). There was no statistically signiffcant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Radiofrequency combined with intense pulsed light has a deffnite effect in the treatment of patients with facial pigmentation complicated with skin aging. It effectively improves facial pigmentation while enhancing skin ffrmness and overall skin texture, without increasing the incidence of adverse reactions, and is beneffcial to improving patient satisfaction, making it worthy of clinical application.