Objective To analyze the application value of hyaluronic acid filling combined with catgut embedding in middle facial rejuvenation. Methods Sixty patients who underwent facial rejuvenation treatment in our hospital from May 2022 to May 2023 were selected and divided into control group and observation group by random number table method, with 30 patients in each group. The control group was treated with catgut embedding, while the observation group was treated with catgut embedding combined with hyaluronic acid filling. The clinical efficacy, treatment satisfaction and adverse reactions were compared between the two groups. Results The improvement effects of apple muscle lifting, middle facial skin tightening and nasolabial groove in the observation group were better than those in the control group, and the differences were statistically significant (P<0.05). The treatment satisfaction of the observation group was 96.67%, which was higher than 76.67% of the control group, and the difference was statistically significant (P<0.05). The incidence of adverse reactions in the observation group was 6.67%, which was lower than 26.67% in the control group, and the difference was statistically significant (P<0.05). Conclusion The effect of hyaluronic acid filling combined with catgut embedding in middle facial rejuvenation is ideal. This method is safe and can effectively improve patients' satisfaction with treatment.