To explore the clinical effect of micro needle mesotherapy combined with picosecond laser in the treatment of chloasma. Methods A total of 84 patients with chloasma admitted to Huahan Medical Beauty Clinic in Wuxi from April 2020 to June 2023 were randomly divided into control group and experimental group, with 42 patients in each group. The control group was treated with picosecond laser, the experimental group was treated with micro needle mesotherapy combined with picosecond laser. The chloasma regression rate, skin improvement and satisfaction were compared between the two groups. Results The regression rate of chloasma in the experimental group was 40.79%, which was higher than 25.13% in the control group (P <0.05). The gloss score, elasticity index and pore thickness score of the experimental group were better than those of the control group (P <0.05). The satisfaction scores of the experimental group were higher than those of the control group (P <0.05). Conclusion The effect of micro needle mesotherapy combined with picosecond laser in the treatment of chloasma is good, which can effectively promote the regression of chloasma, improve the skin state of patients, and patients have higher satisfaction with the treatment plan.