Objective To explore the effect of gold microneedle radiofrequency in facial rejuvenation treatment. Methods Totally 80 patients who underwent facial rejuvenation treatment in the Affiliated Drum Tower Hospital of Nanjing University Medical School from March to October 2023 were selected as the research subjects, and they were randomly divided into control group and observation group, with 40 patients in each group. The control group was treated with fractional laser, and the observation group was treated with gold microneedle radiofrequency. The aesthetic improvement, skin condition and complications were compared between the two groups. Results The total improvement rate of aesthetics in the observation group was 97.50%, which was higher than 82.50% in the control group (P <0.05). After intervention, the scores of skin elasticity, skin moisture, skin dark spots and skin pores in the observation group were higher than those in the control group (P <0.05). The incidence of complications in the observation group was 2.50%, which was lower than 20.00% in the control group (P <0.05). Conclusion The application of gold microneedle radiofrequency in facial rejuvenation treatment is effective, which can elevate the degree of aesthetic improvement, improve the skin condition, reduce the incidence of post-treatment complications, and have high application safety.