Objective To explore the effect of subcutaneous cosmetic suture in episiotomy. Methods A total of 368 postpartum women in Jurong People's Hospital from March 2023 to February 2024 were selected and divided into control group (184 postpartum women) and observation group (184 postpartum women) by random number table method. The control group was given episiotomy suture, and the observation group was given subcutaneous cosmetic suture. The suture time, swelling score, pain score, knot condition and incision healing after suture were compared between the two groups. Results The suture time of the observation group was shorter than that of the control group, and the swelling score and pain score on the 1st, 2nd and 3rd day after operation were lower than those of the control group (P<0.05). There were no 3 degrees in both groups, but the proportion of 0 degree in the observation group was higher than that in the control group, and the proportion of 1 degree and 2 degree was lower than that in the control group (P<0.05). The degree of incision healing in the observation group was higher than that in the control group (P<0.05). Conclusion Subcutaneous cosmetic suture can not only shorten the suture time after episiotomy, but also relieve the pain and promote the healing of incision, which has high clinical significance.