Objective To analyze the effect of skin grafting combined with scar plastic surgery on the cosmetic effect of burn patients. Methods A total of 80 patients with deep burns admitted to our hospital from September 2018 to September 2022 were selected as the research objects. They were divided into control group (autologous medium-thickness sheet transplantation, 40 patients) and observation group (skin grafting surgery+scar plastic surgery, 40 patients) by random number table method. The clinical operation indexes, cosmetic satisfaction, scar restoration condition and scar hyperplasia degree were compared between the two groups. Results The secondary operation rate of the observation group was 2.55%, which was lower than 24.00% of the control group, while the skin graft survival rate was 97.50%, which was higher than 85.00% of the control group, and the difference was statistically significant (P