Objective To analyze the efficacand safety of tranexamic acid combined with 1064 nm Q-switched laser in the treatment of female chloasma. Methods A total of 62 female patients with chloasma in our department from March 2019 to March 2021 were selected. According to the treatment methods, they were divided into the carbamate combined with 1064 nm Q-switched laser treatment group (combined treatment group) and the single 1064 nm Q-switched laser treatment group (single treatment group), with 31 cases in each group. The facial lesion area, chloasma severity, lesion severity, symptom score, clinical effacy, incidence of adverse reactions, recurrence and aesthetics were compared between the two groups. Results The area of facial lesions in the combined treatment group was less than that in the single treatment group, and the differencewas statistically significant(P<0.05). The severity score of chloasma, MASI score, erythema index and recurrence rate in the combined group were lower than those in the single treatment group, and the differenceswere statistically significant(P<0.05). The total effectiverate of the combined treatment group was 80.65%, which was higher than 51.61% of the single treatment group, and the diference was statistically signifiant (P<0.05). There was no signifiant diference in the total incidence of adverse reactions between the two groups (P>0.05). The beauty of the combined treatment group was 87.10%, which was higher than 61.29% of the single treatment group, and the differencewas statistically significant(P<0.05). Conclusion The curative effectof tranexamic acid combined with 1064 nm Q-switched laser in the treatment of female chloasma is better than that of 1064 nm Q-switched laser alone, and it can effectively ensure the safet.