Objective To analyze the effect of pulsed dye laser combined with carbon dioxide fractional laser treatment on scar improvement in patients with hypertrophic scar. Methods A total of 68 patients with hypertrophic scar admitted to our hospital from October 2021 to October 2023 were selected as the research subjects. According to different treatment methods, they were divided into the control group and the observation group, with 34 patients in each group. The control group was given carbon dioxide fractional laser treatment, and the observation group was combined with pulsed dye laser treatment. The scar thickness, scar area, pruritus and pain, scar improvement and adverse reactions were compared between the two groups. Results After treatment, the scar thickness and scar area in the observation group were lower than those in the control group (P <0.05). After treatment, the scores of pruritus and pain in the observation group were lower than those in the control group (P <0.05). After treatment, the scores of vascular distribution, color, thickness and softness in the observation group were all lower than those in the control group (P <0.05). The incidence of adverse reactions in the observation group (8.82%) was lower than that in the control group (32.35%) (P <0.05). Conclusion For patients with hypertrophic scar, the treatment with pulsed dye laser combined with carbon dioxide fractional laser has an ideal effect, which can reduce the scar area and thickness, alleviate pain, and improve the scar condition. Additionally, it can effectively prevent the incidence of adverse reactions, which is beneficial to the recovery of patients.