Objective To investigate the effect of hyaluronic acid injection filling combined with superficial cervical plexus anesthesia on pain and comfort in patients with neck skin aging. Methods From February 2023 to January 2024, 86 patients with neck skin aging treated with hyaluronic acid injection filling in Shanghai Weijiu Medical Beauty Outpatient Department were randomly divided into control group and observation group, with 43 patients in each group. The control group was given routine external application of anesthetics when hyaluronic acid injection was filled, and the observation group was given superficial cervical plexus anesthesia when hyaluronic acid injection was filled. The degree of pain improvement and comfort score were compared between the two groups. Results The VAS score of the observation group was lower than that of the control group, and the difference was statistically significant (P <0.05). The scores of psychological comfort, physiological comfort, social comfort and environmental comfort in the observation group were higher than those in the control group, and the differences were statistically significant (P <0.05). Conclusion Hyaluronic acid injection filling combined with superficial cervical plexus anesthesia can improve the pain and comfort of patients with neck skin aging, which can further reduce the pain of patients and enhance the comfort of treatment. It is worthy of clinical application.