Objective To explore the effect and safety of hyaluronic acid combined with type A botulinum toxin injection in the treatment of periocular rejuvenation. Methods A total of 100 patients who underwent periocular rejuvenation in the Department of Plastic Surgery of our hospital from January to December 2023 were selected as the research objects. They were divided into control group and observation group according to the random number table method, with 50 patients in each group. The control group was treated with conventional plastic surgery, and the observation group was treated with hyaluronic acid combined with type A botulinum toxin injection on the basis of the control group. The clinical efficacy, surgical satisfaction, recovery time and adverse reactions were compared between the two groups. Results The total effective rate of treatment in the observation group was 96.00%, which was higher than 78.00% in the control group (P <0.05). The surgical satisfaction score of the observation group was higher than that of the control group (P <0.05). The recovery time of the observation group was shorter than that in 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 Hyaluronic acid combined with type A botulinum toxin injection is effective in the treatment of periocular rejuvenation, which can improve the therapeutic effect, improve the satisfaction of surgery, shorten the postoperative recovery time, and will not increase the incidence of adverse reactions.