Objective To explore the effect of single-visit root canal therapy combined with ceramic veneer restoration on gingival aesthetic index in patients undergoing aesthetic restoration of anterior teeth. Methods A total of 120 patients requiring root canal treatment and aesthetic restoration of anterior teeth treated at Suzhou Aiyamei Dental Clinic from January 2023 to January 2025 were selected as the research subjects. According to the random number table method, they were divided into the control group and the observation group, with 60 patients in each group. The control group received multiple-visit root canal therapy combined with all-ceramic crown restoration, and the observation group received single-visit root canal therapy combined with ceramic veneer restoration. The treatment success rate, treatment course, pain intensity, gingival aesthetic index, restoration color matching degree, satisfaction and complication rate were compared between the two groups. Results The treatment success rate of the observation group was higher than that of the control group, but the difference was not statistically signiffcant (P>0.05). The average treatment course and clinical visits of the observation group were lower than those of the control group (P<0.05). The VAS scores of the observation group immediately after treatment and at 24 and 72 h after treatment were lower than those of the control group (P<0.05). The PES score in the observation group at 6 months after treatment was higher than that in the control group (P<0.05). The restoration color matching rate of the observation group was better than that of the control group (P<0.05). The satisfaction rate of the observation group was 93.33%, which was higher than 81.67% of the control group (P<0.05). The incidence of complications in the observation group (3.33%) was lower than that in the control group (15.00%) (P<0.05). Conclusion Single-visit root canal therapy combined with ceramic veneer restoration is effective. It can relieve postoperative pain, shorten treatment course, reduce hospital visits, improve aesthetic effect and patient satisfaction, and reduce the incidence of long-term complications.