Objective To explore the application effect of sodium alginate repair dressing combined with tacrolimus ointment in the adjuvant treatment of atopic dermatitis in children. Methods A total of 64 children with atopic dermatitis who were treated in our hospital from January to December 2022 were randomly divided into control group and observation group, with 32 children in each group. The control group was treated with tacrolimus ointment, and the observation group was treated with sodium alginate repair dressing on this basis. The clinical efficacy, adverse reactions, quality of life, sleep quality, skin lesion area, pain score and skin barrier related indicators were compared between the two groups. Results The total effective rate of treatment in the observation group was 93.75%, which was higher than 84.38% in the control group (P <0.05). The incidence of adverse reactions in the observation group was 9.38%, which was lower than 18.75% in the control group (P <0.05). The quality of life score of the observation group was (85.47±8.62)scores, which was higher than (74.62±6.14)scores of the control group (P <0.05). The lesion area of the observation group was (18.74±2.61)mm2, which was lower than (25.47±3.58)mm2 of the control group (P <0.05). After treatment, the pain score of the observation group was (2.74±0.28)scores, which was lower than (4.52±0.56)scores of the control group (P <0.05). The cuticle water content and sebum content in the observation group were higher than those in the control group (P <0.05). Conclusion Sodium alginate repair dressing combined with tacrolimus ointment can improve the clinical efficacy of children with atopic dermatitis, improve their quality of life and sleep, reduce the area of skin lesions, relieve pain, repair skin barrier and reduce adverse reactions. It is worthy of clinical application.