Objective: To evaluate the clinical efficacy and aesthetic outcomes of resin aesthetic restoration in the treatment of anterior tooth defects.Methods: A total of 130 patients with anterior tooth defects treated between September 2023 and October 2024 were enrolled and randomly allocated to an observation group and a control group by a random number table, with 65 patients in each group. The control group received conventional restorative treatment, while the observation group underwent resin aesthetic restoration. The treatment efficacy, aesthetic outcomes, clinical quality and stability of restorations, and incidence of complications were compared between the two groups.Results: The total effective rate in the observation group was significantly higher than that in the control group (P < 0.05). The observation group achieved higher scores in color matching, morphological harmony, surface gloss, and overall aesthetic evaluation of the restorations compared with the control group (P < 0.05). The observation group also demonstrated higher scores in marginal adaptation, marginal integrity, and surface quality of the restorations (P < 0.05), while the incidence of marginal staining was lower than that in the control group (P < 0.05). In addition, the overall complication rate in the observation group was significantly lower than that in the control group (P < 0.05).Conclusion: Resin aesthetic restoration for anterior tooth defects can significantly improve the treatment effective rate, enhance the aesthetic performance and clinical quality of restorations, and reduce the incidence of related complications. It demonstrates favorable clinical efficacy and aesthetic advantages and is worthy of clinical application and promotion.