Objective To explore the effect of emergency cosmetic suture in patients with facial trauma and its influence on skin aesthetics. Methods A total of 80 patients with facial trauma admitted to Yancheng Institute of Technology from April 2019 to February 2024 were selected as the research objects. They were divided into control group and study group according to the random number table method, with 40 patients in each group. The control group was given debridement suture, and the study group was given emergency cosmetic suture. The clinical efficacy, knot reaction, pain degree, skin aesthetics and quality of life were compared between the two groups. Results The total effective rate of treatment in the study group was 97.50%, which was higher than 85.00% in the control group (P <0.05). The proportion of 0 degree of knot reaction in the study group was higher than that in the control group, and the proportions of Ⅰ, Ⅱ and Ⅲ degrees were lower than those in the control group (P <0.05). The VAS score of the study group was lower than that of the control group (P <0.05). The VACS score of the study group was lower than that of the control group (P <0.05). The scores of physiology, psychology, social relations and environment in the study group were higher than those in the control group (P <0.05). Conclusion The application of emergency cosmetic suture in patients with facial trauma is effective, which can effectively repair facial trauma wounds, accelerate their healing speed, reduce knot reaction, prevent scar formation, help reduce pain, and improve patients' skin aesthetics and quality of life.