Objective:? To observe the efficacy and safety of single-needle radiofrequency combined with oral medication in the treatment of moderate to severe facial acne. Methods:? 40 patients with moderate to severe facial acne admitted to the Department of Dermatology, Zhangjiagang First People’s Hospital from March 2022 to March 2023 were enrolled and divided into an experimental group and a control group according to treatment methods, with 20 cases in each group. The control group was treated with roxithromycin combined with viaminate capsules, while the experimental group received single?needle radiofrequency plus roxithromycin and viaminate capsules. Results: After 8 weeks of treatment, the total effective rate of the study group (90%) was significantly higher than that of the control group (60%, P<0.05). The acne severity score of the study group was significantly lower, and the GAIS score was significantly higher than those of the control group (both P<0.05). The total incidence of adverse reactions in the study group was higher but with no statistical difference (P>0.05). Conclusion: Single-needle radiofrequency combined with oral medications is more effective than oral medications alone for moderate to severe facial acne, with mild adverse reactions and high safety, worthy of clinical promotion.