Objective To investigate the effect of type A botulinum toxin for injection combined with eye bag plastic surgery in the treatment of periocular skin relaxation. Methods A total of 1200 patients with periocular skin relaxation received in our hospital from June 2020 to June 2022 were selected as the research objects and divided into control group and observation group according to the random number table method, with 600 cases in each group. The control group was treated with eye bag plastic surgery, and the observation group was treated with type A botulinum toxin for injection combined with eye bag plastic surgery. The clinical efficacy, complications, postoperative crow's feet, eyelid bag and satisfaction were compared between the two groups. Results The rates of skin color enhancement, lid bag reduction and crow's feet improvement in the observation group were higher than those in the control group (P0.05). The incidence of eyelid bags and crow 's feet in the observation group was lower than that in the control group (P