Objective To explore the effect of 308 nm excimer light on skin aesthetics in patients with vitiligo. Methods A total of 78 patients with vitiligo admitted to the Department of Dermatology, the Fourth Afffliated Hospital of Nanjing Medical University from September 2024 to September 2025 were selected as the research subjects, and they were divided into the control group and the observation group by the random number table method, with 39 patients in each group. The control group was treated with 311 nm narrow-band ultraviolet B, and the observation group was treated with 308 nm excimer light. The clinical efffcacy, inffammatory factor levels, skin aesthetics and pigment recovery indicators were compared between the two groups. Results The total effective rate of the observation group (92.31%) was higher than that of the control group (74.36%) (P<0.05). The levels of all inffammatory factors in the observation group after treatment were lower than those in the control group (P<0.05). The scores of leukoplakia appearance acceptance, overall skin coordination and social aesthetic conffdence in the observation group after treatment were higher than those in the control group (P<0.05). The repigmentation initiation time in the observation group was shorter than that in the control group, and the improvement rate of lesion area was better than that in the control group (P<0.05). Conclusion The application of 308 nm excimer light in the treatment of vitiligo can not only accelerate pigment recovery and improve skin aesthetics, but also effectively inhibit the expression of inffammatory factors, thus achieving better clinical efffcacy.