objective to observe the effect of micro-focused ultrasound in facial skin aging beauty. Methods a total of 68 patients with aging facial 2023 from January to 2024 were randomly divided into control group and Observation Group. The control group was treated with light injection of hyaluronic acid water, and the observation group was treated with micro-focused ultrasound on the basis of the control group, the cosmetic effect, the score of facial wrinkles (WSRS) , the score of global aesthetic improvement (Gais) , the score of pain (Vas) , the skin index, the incidence of complications and the treatment satisfaction were observed and compared between the two groups. Results: the total effective rate of the observation group was 94.12% , which was higher than that of the control group (82.35% , p < 0.05) , and the scores of WSRS, GAIS and Vas in both groups were lower than that before treatment, and the observation group was lower than that of the control group (p < 0.05) The elasticity and water content in both groups were higher than those before treatment, and the skin loss, sebum content, heme and melanin in both groups were lower than those before treatment, and the elasticity and water content in the observation group were higher than those in the control group, the skin loss, sebum content, heme and melanin in the observation group were lower than those in the control group (p < 0.05) , and the complication rate in the observation group was 8.82% lower than that in the control group (20.59% , p > 0.05) The satisfaction degree of the Observation Group (100.00%) was higher than that of the control group (85.29%)(p < 0.05) . Conclusion: micro-focused ultrasound is effective in the treatment of facial skin aging. It can increase the total effective rate, improve the skin condition, reduce the score of facial wrinkles and pain, prevent complications and improve the satisfaction of treatment, it has important clinical application value.