Objective To analyze the effect of expanded deltopectoral flap pedicled transfer repair on postoperative tissue contracture rate and pain degree after facial and neck burn scar. Methods From February 2019 to June 2023, 60 patients with scars after facial and neck burns admitted to Hebei General Hospital and the First Hospital of Hebei Medical University were selected as the research objects. They were divided into control group and observation group by random number table method, with 30 patients in each group. The control group was treated with free skin graft, and the observation group was treated with pedicled transfer repair of expanded deltopectoral flap. The repair tissue contracture rate, repair effect, complications and pain degree were compared between the two groups. Results The repair tissue contracture rate of the observation group was lower than that of the control group at 1 and 6 months after operation (P <0.05). The scores of tissue surface leveling, skin color, sensory recovery, elastic texture and overall aesthetic feeling in the observation group were higher than those in the control group (P <0.05). The incidence of complications in the observation group was lower than that in the control group (P <0.05). The VAS score of the observation group was lower than that of the control group at 1 and 6 months after operation (P <0.05). Conclusion The application of expanded deltopectoral flap pedicled transfer repair in the treatment of scars after facial and neck burns can improve the repair effect, reduce the degree of postoperative pain and the incidence of complications, and reduce the incidence of postoperative repair tissue contracture. It has high clinical application value.