Objective To explore the efficacy and safety between composite resin and porcelain veneer in aesthetic restoration of anterior teeth. Methods A total of 80 patients (80 affected teeth) who received aesthetic restoration of anterior teeth in Huangdao District Central Hospital from January 2023 to September 2024 were selected. According to different restoration methods, they were divided into the porcelain veneer group and the composite resin group, with 40 patients in each group. The porcelain veneer group was treated with porcelain veneer during restoration, and the composite resin group was treated with composite resin. The restoration success rate, restoration aesthetics, periodontal indexes[periodontal pocket depth (PD), plaque index (PLI), sulcus bleeding index (SBI) and gingival index (GI)] and complications were compared between the two groups. Results The restoration success rate in the composite group was 97.50%, which was higher than 85.00% in the porcelain veneer group (P <0.05). After restoration, the PD, SBI, GI and PLI in the two groups were lower than those before restoration, and those in the composite group were lower than those in the porcelain veneer group (P <0.05). The scores of retention, color matching, surface smoothness and tooth morphology in the composite group were higher than those in the porcelain veneer group (P <0.05). The incidence of complications in the composite group was lower than that in the porcelain veneer group (P <0.05). Conclusion The application of composite resin in aesthetic restoration of anterior teeth has a higher restoration success rate, which can improve the oral health status, enhance the restoration aesthetics, and reduce the incidence of complications. It is worthy of clinical application.