To analyze the effect of rehabilitation therapy combined with muscle strengthening training in patients with hand burn after plastic surgery. Methods A total of 130 patients with hand burns who underwent plastic surgery in our hospital from January 2022 to January 2023 were randomly divided into control group and observation group, with 65 patients in each group. The control group received routine intervention, and the observation group received rehabilitation therapy combined with muscle strengthening training. The recovery of hand function, joint mobility and daily living ability were compared between the two groups. Results The total recovery rate of hand function in the observation group was 98.46%, which was higher than 76.92% of the control group (P <0.05). After intervention, the scores of TAM and Carroll hand function test in the observation group were higher than those in the control group (P <0.05). The ADL score of the observation group was higher than that of the control group (P <0.05). Conclusion For patients with hand burn after plastic surgery, rehabilitation therapy combined with muscle strengthening training has a good effect, which can effectively promote the recovery of hand function, improve the range of motion, and improve their daily living ability.