Objective To explore the effect of anterior wall fenestration in the treatment of postauricular sebaceous cyst with infection. Methods A total of 76 patients with retroauricular sebaceous cyst and infected abscess admitted to our hospital from February 2021 to December 2022 were selected as the research objects. According to the random number table method, they were divided into control group and study group, with 38 cases in each group. The control group was treated with surgical resection after abscess incision and drainage, and the study group was treated with fenestration of anterior wall of cyst. The clinical efficacy, satisfaction, quality of life and wound healing were compared between the two groups. Results The total effective rate of treatment in the study group was 97.37%, which was higher than 84.21% in the control group (P<0.05). The satisfaction of the study group was 100.00%, which was higher than 86.84% of the control group (P<0.05). The quality of life scores of each dimension in the study group were better than those in the control group (P<0.05). The wound healing time and the ratio of scar diameter to abscess long axis diameter in the exploration group were better than those in the control group (P<0.05). Conclusion The use of cyst anterior wall fenestration in the treatment of postauricular sebaceous cyst with infection abscess is effective, which can improve patient satisfaction, improve their quality of life, and promote wound healing as soon as possible. It is worthy of clinical application.