Objective To explore the application effect of scar core resection combined with type A botulinum toxin injection and shallow X-ray radiation in the treatment of keloid. Methods A total of 51 patients with keloid admitted to the Department of Cosmetic Dermatology, Affiliated Hospital of Zunyi Medical University from June 2021 to January 2022 were selected as the research objects. They were divided into group A, group B and group C by random number table method, with 17 cases in each group. Group A was treated with scar core resection combined with type A botulinum toxin, group B was treated with scar core resection combined with shallow x-ray radiation, and group C was treated with scar core resection combined with type A botulinum toxin for injection and shallow X-ray radiation. The scar condition, clinical efficacy and quality of life of the three groups were compared. Results After treatment, the VSS score and VAS score of group C were lower than those of group A and group B, the differences were statistically significant (P<0.05). The total effective rate of treatment in group C was higher than that in group A and group B, the differences were statistically significant (P<0.05). The scores of all dimensions of quality of life in group C were higher than those in group A and group B, the differences were statistically significant (P<0.05). Conclusion The application effect of scar kernel resection combined with type A botulinum toxin injection and shallow X-ray radiation in the treatment of keloid is good, which can effectively improve the scar condition, improve the quality of life, and is worthy of clinical application.