Objective To explore the effect of dexmedetomidine combined anesthesia on hemodynamic indicators and pain in patients undergoing surgical cosmetic suture. Methods A total of 80 patients undergoing surgical cosmetic suture admitted to Suzhou Kowloon Hospital from July 2024 to July 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 40 patients in each group. The control group received routine anesthesia plan, and the observation group received dexmedetomidine combined anesthesia on the basis of the control group. The hemodynamic indicators, recovery-related indicators, pain and adverse reaction rate were compared between the two groups. Results The HR and MAP in the observation group at T1 and T2 were lower than those in the control group (P <0.05). The recovery time of spontaneous breathing, eye-opening time and extubation time in the observation group after surgery were shorter than those in the control group (P <0.05). There was no statistically significant difference in VAS scores between the two groups at 1, 2 and 3 days after surgery (P >0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion The application of dexmedetomidine combined anesthesia in surgical cosmetic suture can provide a stable hemodynamic state, promote postoperative recovery, and exert an analgesic effect without increasing the risk of adverse reactions, with excellent overall safety and effectiveness.