Objective To analyze the effect of eye bag plastic surgery combined with type A botulinum toxin for injection in the treatment of periocular skin relaxation. Methods A total of 70 patients with periocular skin relaxation admitted to our hospital from October 2019 to October 2022 were selected and randomly divided into observation group (n=35) and control group (n=35). The control group was treated with eye bag plastic surgery, and the observation group was treated with type A botulinum toxin for injection on the basis of the control group. The clinical treatment indexes, aesthetic scores, incidence of adverse reactions and treatment satisfaction were compared between the two groups. Results After treatment, the scores of fishtail lines, eye bags and skin color enhancement in the observation group were higher than those in the control group (P