Objective To investigate the effect of 1565 nm non-ablative fractional laser combined with sodium hyaluronate composite solution injection on skin laxity of abdominal striae gravidarum. Methods A total of 40 patients with abdominal striae gravidarum admitted to our hospital from March to October 2025 were selected, and they were divided into the control group and the experimental group by the random number table method, with 20 patients in each group. The control group received 1565 nm non-ablative fractional laser treatment, and the experimental group received local injection of sodium hyaluronate composite solution on the basis of the control group. The clinical efficacy, skin laxity, patient satisfaction and adverse reaction rate were compared between the two groups. Results The total effective rate of the experimental group was 90.00%, which was higher than 60.00% of the control group (P <0.05). At 2 months after treatment, R0 in the two groups was lower than that before treatment, and R7 was higher than that before treatment. R0 in the experimental group was lower than that in the control group, and R7 was higher than that in the control group (P <0.05). The satisfaction rate of the experimental group was 95.00%, which was higher than 65.00% of the control group (P <0.05). The incidence of adverse reactions in the experimental group was 10.00%, which was higher than 5.00% in the control group, but the difference was not statistically significant (P >0.05). Conclusion 1565 nm non-ablative fractional laser combined with sodium hyaluronate composite solution injection can effectively improve postpartum abdominal striae gravidarum and skin laxity, with favorable safety.