Objective To compare the clinical effects of cryotherapy, laser and surgery in the treatment of skin pigmented nevus. Methods A total of 120 patients with skin pigmented nevus admitted to our hospital from January 2021 to May 2022 were selected as the research objects. According to the random number table method, they were divided into cryotherapy group, laser group and operation group, with 40 cases in each group. The cryotherapy group was treated with cryotherapy, the laser group was treated with laser, and the surgery group was treated with surgery. The clinical efficacy, recurrence and complications of the three groups were compared. Results The total effective rate of surgery group was 97.50%, which was higher than 77.50% of cryotherapy group and 80.00% of laser group, the difference was statistically significant (P