To investigate the effect of photorejuvenation combined with Q-switched laser in the treatment of chloasma. Methods A total of 277 patients with chloasma admitted to Hezhou People's Hospital from January 2020 to April 2023 were selected as the research objects and divided into control group (n =135) and combined group (n =142) according to the random number table method. The control group was treated with Q-switched laser, and the combined group was treated with photorejuvenation combined with Q-switched laser. The clinical efficacy, skin test results and adverse reactions were compared between the two groups. Results The total effective rate of the combined group was 93.66%, which was higher than 84.44% of the control group (P <0.05). After treatment, the scores of wrinkles, texture, purple precipitation, pores and stains in the combined group were lower than those in the control group (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion The effect of combined photonrejuvenation combined with Q-switched laser in the treatment of chloasma is ideal, which can improve the curative effect, improve the skin condition of patients, and will not increase the risk of adverse reactions.