Objective To evaluate the clinical efficacy of intensive pulsed light and CO2 fractional laser in the treatment of facial skin photoage. Methods The databases of CNKI, Wanfang, VIP, PubMed, Cochrane, Embase and Web of Science were searched by computer to collect randomized controlled trials (RCTs) of intensive pulsed light and CO2 fractional laser in the treatment of facial skin photoage. The retrieval time was limited to August 2024. Two researchers independently screened the literature and extracted the data. Meta-analysis of the outcome indicators was performed using RevMan 5.3, and the publication bias test was performed. Results A total of 10 RCTs involving 969 patients were included. Meta-analysis showed that the total effective rate of CO2 fractional laser in the treatment of facial skin photoage was better than that of intensive pulsed light [RR =1.14, 95%CI (1.07, 1.21), Z =4.04, P <0.0001], and the incidence of adverse reactions was lower than that of intense pulsed light [RR =0.51, 95%CI (0.32, 0.79), Z =2.99, P =0.003]. Conclusion The curative effect of CO2 fractional laser on facial skin photoage is better than that of intensive pulsed light, and the adverse reactions are less.