Objective To explore the clinical effect of photodynamic combined with surgery in the treatment of keloid. Methods A total of 60 patients with keloid admitted to our hospital from November 2019 to September 2021 were selected as the research objects and divided into experimental group and control group by random number table method, with 30 cases in each group. The control group was treated with Diprospan local closed scar tissue; the experimental group was treated with surgical resection of scar tissue combined with photodynamic therapy. The clinical efficacy and recurrence of the two groups were compared. Results The total effective rate of treatment in the experimental group was 96.67%, which was higher than 73.33% in the control group, and the difference was statistically significant (P<0.05). The recurrence rate of the experimental group was 10.00%, which was lower than 33.33% of the control group, and the difference was statistically significant (P<0.05). Conclusion Photodynamic therapy combined with surgery has a definite clinical effect in the treatment of keloid, and the recurrence rate during follow-up is low, which is worthy of clinical application.