Objective To explore the effectiveness of cosmetic repair for patients with small area skin trauma in emergency department. Methods A total of 30 patients with small area skin trauma admitted to the emergency department of our hospital from January 2020 to January 2023 were randomly divided into control group and experimental group, with 15 patients in each group. The control group was treated with routine repair, and the experimental group was treated with cosmetic repair. The repair effect, treatment satisfaction, wound healing time, quality of life and complications were compared between the two groups. Results The excellent and good rate of repair in the experimental group was 93.33%, which was higher than 60.00% in the control group (P <0.05). The treatment satisfaction of the experimental group was 93.33%, which was higher than 53.33% of the control group (P <0.05). The wound healing time of the experimental group was (5.08±1.49)d, which was shorter than (9.44±3.32)d of the control group (P <0.05). The scores of mental health, physiological function, social function and body pain in the experimental group were higher than those in the control group (P <0.05). The incidence of complications in the experimental group was 6.67%, which was lower than 53.33% in the control group (P <0.05). Conclusion The application of cosmetic repair in patients with small area skin trauma in emergency department is effective, which can improve the repair effect, and the patient satisfaction is high, and the incidence of postoperative scar is low. Meanwhile, it is conducive to promoting wound healing and improving the quality of life of patients.