【 Abstract 】Objective To explore the clinical effect of Er: YAG laser combined with periodontal orthodontics in the treatment of aggressive periodontitis (AgP) and its influence on aesthetics. Methods A total of 100 patients with AgP admitted to our hospital from January 2023 to July 2024 were randomly divided into two groups, 50 patients in the control group were treated with periodontal orthodontics, and 50 patients in the study group were treated with Er: YAG laser combined with periodontal orthodontics. The inflammatory factors, periodontal health indicators and facial aesthetics were compared between the two groups.Results After treatment, the levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin -4(IL-4) and interleukin -6(IL-6) in gingival crevicular fluid in the study group were lower than those in the control group (P < 0.05). Plaque index (PLI), probing depth (PD), gingival index (GI) and clinical attachment loss (CAL) in the study group were lower than those in the control group after treatment (P < 0.05). The height of alveolar bone defect, the depth of periodontal pocket and the coverage of anterior teeth in the study group were lower than those in the control group after treatment (P < 0.05). Conclusion Er: YAG laser combined with periodontal orthodontic treatment can reduce the level of inflammatory factors in gingival crevicular fluid, improve its periodontal index and improve its facial aesthetics.