Objective To analyze the effect of Liangxue Wuhua decoction combined with dye laser in the treatment of rosacea. Methods A total of 76 patients with rosacea admitted to the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from January 2023 to January 2024 were randomly divided into control group and observation group, with 38 patients in each group. The control group was treated with modified Liangxue Wuhua decoction, and the observation group was treated with modified Liangxue Wuhua decoction combined with dye laser. The recovery of skin lesions, TCM syndrome scores and adverse reactions were compared between the two groups. Results After treatment, the skin lesion score of the observation group was lower than that of the control group, and the difference was statistically significant (P <0.05). After treatment, the scores of erythema, dryness, papules, pain, skin flushing and pruritus in the observation group were lower than those in the control group, the differences were statistically significant (P <0.05). The incidence of adverse reactions in the observation group was 2.63%, which was lower than 18.42% in the control group, and the difference was statistically significant (P <0.05). Conclusion The clinical effect of Liangxue Wuhua decoction combined with dye laser in the treatment of rosacea is good. It can effectively promote the recovery of skin lesions and improve the symptoms of acne. Meanwhile, the incidence of adverse reactions after treatment is low and the safety is high, which provides new ideas and new methods for the treatment of rosacea.