To investigate the aesthetic effect and safety of all-ceramic crown in anterior aesthetic restoration. Methods A total of 70 patients with anterior aesthetic restoration admitted to our hospital from December 2021 to December 2022 were selected as the research objects. They were divided into control group and observation group by random number table method, with 35 patients in each group. The control group was treated with metal alloy porcelain for aesthetic restoration, and the observation group was treated with all-ceramic crown for aesthetic restoration. The repair effect, aesthetic effect and adverse reactions were compared between the two groups. Results The total effective rate of repair in the observation group was 97.14%, which was higher than 82.86% in the control group, and the difference was statistically significant (P <0.05). The gingival color score and overall aesthetics score of the observation group were higher than those of the control group, and the gingival index score was lower than that of the control group, the differences were statistically significant (P <0.05). The incidence of adverse reactions in the observation group was 5.71%, which was lower than 31.43% in the control group, and the difference was statistically significant (P <0.05). Conclusion The repair effect of all-ceramic crown in anterior aesthetic restoration is ideal, and it can meet the aesthetic repair needs of patients. At the same time, it is safe and worthy of clinical application.