Objective To analyze the effect of hyaluronic acid combined with type A botulinum toxin on oral lips aging. Methods A total of 74 patients with lip aging admitted to our hospital from June 2021 to June 2023 were selected as the research objects. They were divided into control group and observation group by random number table method, with 37 patients in each group. The control group was treated with type A botulinum toxin, and the observation group was treated with hyaluronic acid on the basis of the control group. The clinical efficacy, psychological state, pain degree and satisfaction of the two groups were compared. Results The height and angle of each part of the lip in the observation group were better than those in the control group (P <0.05). After treatment, the scores of SAS and SDS in the observation group were lower than those in the control group (P <0.05). The VAS score of the observation group was lower than that of the control group, but the difference was not statistically significant (P >0.05). The satisfaction score of the observation group was higher than that of the control group (P <0.05). Conclusion The effect of hyaluronic acid combined with type A botulinum toxin in patients with lip aging is better, which can improve the psychological state and pain degree of patients, and then improve patient satisfaction. It is worthy of clinical application.