Objective To investigate the effect of CO2 fractional laser combined with recombinant type Ⅲ collagen freeze-dried fiber in patients with superficial scar. Methods A total of 50 patients with superficial scar admitted to the Shijiazhuang Maternal and Child Health Hospital/Shijiazhuang Children's Hospital from January to May 2024 were selected as the research objects. They were divided into control group and observation group by random number table method, with 25 patients in each group. The control group was treated with fractional CO2 laser, and the observation group was treated with CO2 fractional laser combined with recombinant type III collagen freeze-dried fiber. The clinical related indexes, clinical efficacy, scar condition and adverse reactions were compared between the two groups. Results The edema time, erythema duration, tingling time and healing time in the observation group were shorter than those in the control group (P <0.05). The total effective rate of treatment in the observation group was 96.00%, which was higher than 68.00% in the control group (P <0.05). After treatment, the scores of scar color, thickness, vascular distribution and softness in the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group (P <0.05). The incidence of adverse reactions in the observation group was 0, which was lower than 16.00% in the control group (P <0.05). Conclusion C O2 fractional laser combined with recombinant type Ⅲ collagen freeze-dried fiber is effective in patients with superficial scars, which can accelerate the recovery of skin tissue and improve the scar condition. Meanwhile, the incidence of adverse reactions after treatment is low, and the application safety is good.