Objective To analyze the clinical effect of microincision approach rigid internal fixation in the treatment of oral and maxillofacial fractures. Methods A total of 70 patients with oral and maxillofacial fractures admitted to our hospital from February 2020 to March 2022 were selected as the research objects. They were divided into observation group and control group according to the random number table method, with 35 cases in each group. The control group was treated with traditional methods, and the observation group was treated with microincision approach rigid internal fixation. The clinical efficacy, postoperative recovery, complications, language function, chewing function and fixation function, aesthetics and comfort satisfaction scores were compared between the two groups. Results The total effective rate of treatment in the observation group was 94.29%, which was higher than 71.43% in the control group (P<0.05). The satisfactory shape recovery, complete mouth opening recovery, screw loosening and fixation without displacement in the observation group were all better than those in the control group (P<0.05). The total incidence of complications in the observation group was 5.71%, which was lower than 25.71% in the control group (P<0.05). The scores of language function, chewing function, fixation function, aesthetics and comfort satisfaction in the observation group were higher than those in the control group (P<0.05). Conclusion The treatment of microincision approach rigid internal fixation can improve the physiological function of oral and maxillofacial region in patients with oral and maxillofacial fractures, meet the requirements of patients for appearance recovery, improve the quality of life, and have fewer postoperative complications, which is worthy of clinical application.