To explore the effect of subcutaneous island pedicle flap in wound repair after facial skin tumor resection. Methods A total of 60 patients who underwent facial skin tumor resection in our hospital from January 2019 to January 2023 were selected as the research objects. According to the difference of flap application, they were divided into control group and observation group, with 30 patients in each group. The control group was treated with traditional skin flap to repair the wound after facial skin tumor resection, the observation group was treated with subcutaneous island pedicle flap to repair the wound after facial skin tumor resection. The repair effect, complications, pain degree and quality of life were compared between the two groups. Results The total effective rate of repair in the observation group was 93.33%, which was higher than 66.67% in the control group (P <0.05). The incidence of complications in the observation group was 3.33%, which was lower than 20.00% in the control group (P <0.05). The VAS scores of the observation group were lower than those of the control group at 1, 7 and 14 days after operation (P <0.05). The scores of physical function, psychological function, social function and material life in the observation group were higher than those in the control group (P <0.05). Conclusion The application effect of subcutaneous island pedicle flap in wound repair after facial skin tumor resection is ideal, with less postoperative complications and less pain, which can improve the quality of life of patients and promote recovery.