Objective To analyze the clinical effect of local rotation flap repair in the treatment of head and facial soft tissue defects. Methods From June 2022 to June 2023, 60 patients with head and facial soft tissue defects in Beigou Health Center of Xinyi City were selected and divided into control group and study group according to the random number table method, with 30 patients in each group. The control group underwent traditional clinical repair surgery, and the study group underwent local rotation flap repair. The scar condition, complication rate and satisfaction were compared between the two groups. Results After intervention, the VSS scores of each dimension in the study group were lower than those in the control group, and the differences were statistically significant (P <0.05). The incidence of complications in the study group (0) was lower than that in the control group (16.67%), and the difference was statistically significant (P <0.05). The satisfaction of the study group (96.67%) was higher than that of the control group (76.67%), and the difference was statistically significant (P <0.05). Conclusion The introduction of local rotation flap repair in the treatment of head and face soft tissue defects can improve postoperative scar formation, reduce the incidence of complications, and improve postoperative satisfaction of patients, which is worthy of clinical application.