Objective To investigate the effect of optimal pulse technology combined with 1064 nm ultra-picosecond laser in the treatment of chloasma with nevus fusco. Methods From March 2021 to March 2022, 60 patients with chloasma and nevus fusco admitted to our hospital were selected as the research objects. They were divided into observation group and control group by random number table method, with 30 patients in each group. The observation group was treated with optimal pulsed light combined with 1064 nm ultra-picosecond laser, and the control group was treated with 1064 nm picosecond laser. The clinical efficacy, recurrence rate, VISIA skin image analysis results and serum oxidative stress indexes were compared between the two groups. Results The total effective rate of treatment in the observation group was 96.67%, which was higher than 80.00% in the control group (P<0.05). The recurrence rate of the observation group was 3.33% after 12 months of follow-up, which was lower than 20.00% of the control group (P<0.05). After treatment, the scores of color spots, pores, wrinkles, texture and purple matter in the observation group were lower than those in the control group (P<0.05). After the treatment, the serum superoxide dismutase test results of the observation group were higher than those of the control group, and the malondialdehyde and lipid peroxide test results were lower than those of the control group (P<0.05). Conclusion Optimal pulsed light and 1064 nm ultra-picosecond laser are effective in the treatment of chloasma with nevus fusco, and the recurrence rate is low. Meanwhile, it can effectively improve the facial skin of patients and is worthy of clinical application.