To investigate the clinical effect of micro-plasma beam combined with recombinant bovine basic fibroblast growth factor external gel in the treatment of burn hypertrophic scar. Methods A total of 28 patients with burn hypertrophic scar admitted to our hospital from January 2021 to April 2023 were randomly divided into control group and experimental group, with 14 patients in each group. The control group was treated with micro-plasma beam, and the experimental group was treated with micro-plasma beam combined with recombinant bovine basic fibroblast growth factor external gel. The scar improvement, decrustation time, satisfaction and adverse reactions were compared between the two groups. Results The improvement of scar in the experimental group was better than that in the control group after the first, second and third treatment (P <0.05). The decrustation time of the experimental group was shorter than that of the control group after the first, second and third treatment (P <0.05). The satisfaction rate of the experimental group was 85.71%, which was higher than 42.86% of 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 Micro-plasma beam combined with recombinant bovine basic fibroblast growth factor external gel can effectively improve scar symptoms for patients with burn hypertrophic scar, shorten recovery time, improve satisfaction, and will not increase the risk of adverse reactions. It is safe and worthy of clinical application.