Objective To analyze the efficacy and safety of scar deformity repair combined with early systematic rehabilitation training for scar deformity after hand burn in children. Methods From January to December 2023, 100 children with scar deformity after hand burn in our hospital were selected as the research objects. They were randomly divided into control group and observation group, with 50 children in each group. The control group was given scar deformity repair method, and the observation group was given scar deformity repair combined with early systematic rehabilitation training. The hand function, scar status, quality of life and complications were compared between the two groups. Results After treatment, the scores of grip strength test and fine motor function test in the observation group were higher than those in the control group (P <0.05). After treatment, the scores of pigmentation, thickness and softness in the observation group were lower than those in the control group (P <0.05). After treatment, the scores of physiological function, psychological function and social function in the observation group were higher than those in the control group (P <0.05). The incidence of complications in the observation group was 2.00%, which was lower than 14.00% in the control group (P <0.05). Conclusion Scar deformity repair combined with early systematic rehabilitation training has high efficacy and safety in the treatment of scar deformity after hand burn in children, which can effectively improve the hand function and scar condition of children, reduce the incidence of complications, and improve their quality of life.