To study the effect of combination therapy of basic fibroblast growth factor (bFGF) gel and ultra pulsed CO2 fractional laser on acne scar patients. Methods A total of 200 patients with acne scars admitted to our hospital from January 2022 to January 2023 were selected as the research objects. According to the random number table method, they were divided into control group and observation group, with 100 patients in each group. The control group was treated with ultra pulsed CO2 fractional laser, and the observation group was treated with bFGF combined with ultra pulsed CO2 fractional laser. The acne basal depth, clinical efficacy, erythema duration and scab time were compared between the two groups. Results After 30 and 90 days of treatment, the depth of acne base in the observation group was lower than that in the control group (P <0.05). The total effective rate of treatment in the observation group was 97.00%, which was higher than 81.00% in the control group (P <0.05). The duration of erythema and scab in the observation group were shorter than those in the control group (P <0.05). Conclusion bFGF combined with ultra pulsed CO2 fractional laser is effective in the treatment of acne scars, which is beneficial to improve the depth of acne base, shorten the duration of scab and erythema, and promote recovery.