Objective To investigate the effect of ultra-pulsed carbon dioxide fractional laser combined with gold microneedle radiofrequency therapy on patients with facial acne scars. Methods A total of 70 patients with facial acne depressed scars admitted to our hospital from January 2022 to February 2023 were selected as the research objects. They were divided into conventional group and experimental group by random number table method, with 35 patients in each group. The conventional group was treated with gold microneedle radiofrequency, and the experimental group was treated with ultra-pulsed carbon dioxide fractional laser combined with gold microneedle radiofrequency. The acne scar score, prognosis recovery time and aesthetic satisfaction were compared between the two groups. Results After treatment, the acne scar score of the experimental group was lower than that of the conventional group, and the difference was statistically significant (P <0.05). The duration of swelling, healing time and rest time in the experimental group were shorter than those in the conventional group, and the differences were statistically significant (P <0.05). The aesthetic satisfaction of the experimental group was 97.14%, which was higher than 74.29% of the conventional group, and the difference was statistically significant (P <0.05). Conclusion The clinical effect of ultra-pulsed carbon dioxide fractional laser combined with gold microneedle radiofrequency in the treatment of facial acne depressed scars is good, which can effectively repair acne scars, and the prognosis of patients recovers quickly. Meanwhile, it can achieve the repair expectation of patients and is worthy of clinical application.