Objective To explore the effect of intensive pulsed light combined with Q-switched laser in the treatment of facial freckles. Methods From April 2021 to April 2023, 80 patients with facial freckles admitted to the Zhangqiu District Mingshui Sub-district Office Community Health Service Center were randomly divided into control group and study group, with 40 patients in each group. The control group was treated with intensive pulsed light, and the study group was treated with Q-switched laser combined with intensive pulsed light. The clinical efficacy, satisfaction, adverse reactions and recurrence of the two groups were compared. Results The total effective rate of treatment in the study group was 97.50%, which was higher than 82.50% in the control group, and the difference was statistically significant (P<0.05). The satisfaction rate of the study group was 100.00%, which was higher than 85.00% of the control group, and the difference was statistically significant (P <0.05). The incidence of adverse reactions in the study group was 2.50%, which was lower than 22.50% in the control group, and the difference was statistically significant (P <0.05). The recurrence rate of the study group was 2.50%, which was lower than 20.00% of the control group, and the difference was statistically significant (P <0.05). Conclusion The application of intensive pulsed light combined with Q-switched laser in patients with facial freckles is effective, which can improve the total effective rate of treatment, improve the freckle symptoms of patients, and effectively reduce the incidence of adverse reactions and recurrence rate. It is beneficial to improve patient satisfaction and is worthy of clinical application.