Objective To compare the efficacy of CO2 fractional laser and intense pulsed light in the treatment of facial photoaging. Methods A total of 100 patients with facial photoaging admitted to our hospital from January 2017 to January 2018 were randomly divided into control group and observation group, with 50 patients in each group. The control group was treated with intense pulsed light, and the observation group was treated with CO2 fractional laser. The therapeutic effect, incidence of adverse reactions and recurrence rate were compared between the two groups. Results The total effective rate of treatment in the observation group was 96.00%, which was higher than 84.00% in the control group (P<0.05). The incidence of adverse reactions in the observation group was 6.00%, which was lower than 20.00% in the control group (P<0.05). The recurrence rate of the observation group was 6.00%, which was lower than 22.00% of the control group (P<0.05). Conclusion Compared with intense pulsed light, fractional laser technology can effectively improve the satisfaction of patients in the treatment of facial skin photoaging. After treatment, antibiotics should be used to avoid skin infection, and adverse reactions should be prevented through various measures to ensure the therapeutic effect.