Objective To analyze the effect of gold microneedle radiofrequency combined with non-ablative fractional laser on scar severity in patients with facial depressed acne scars. Methods A total of 120 patients with facial depressed acne scars admitted to Shihezi People's Hospital from January 2024 to June 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 60 patients in each group. The control group received single non-ablative fractional laser treatment, and the observation group was treated with gold microneedle radiofrequency combined with non-ablative fractional laser. The scar severity, overall aesthetic improvement, clinical efffcacy, satisfaction and adverse reaction rate were compared between the two groups. Results The ECCA scores of the observation group at 1, 3 and 6 months after treatment were lower than those of the control group (P<0.05). The GAIS score of the observation group at 6 months after treatment was (1.82±0.65)points, which was better than (2.45±0.78)points of the control group. The total effective rate of the observation group was higher than that of the control group (P<0.05). The satisfaction score of the observation group was higher than that of the control (P<0.05). There was no signiffcant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Gold microneedle radiofrequency combined with non-ablative fractional laser has a deffnite curative effect on facial depressed acne scars. It can effectively reduce scar severity, improve the overall aesthetic effect and raise patients' satisfaction, with good safety.