Objective To analyze the effect of surgical guided eruption combined with orthodontics treatment on aesthetic effect and masticatory function in patients with maxillary impacted teeth. Methods A total of 120 patients with maxillary impacted teeth admitted to Suzhou Huaxia Stomatological Hospital from February 2021 to February 2024 were selected as the research subjects, and they were divided into the control group and the observation group according to different treatment strategies, with 60 patients in each group. The control group received surgical guided eruption treatment, and the observation group received surgical guided eruption combined with orthodontics treatment. The clinical efficacy, aesthetic effect, masticatory function and satisfaction were compared between the two groups. Results The total effective rate of the observation group (96.67%) was higher than that of the control group (83.33%) (P <0.05). At 1 year after surgery, the scores of tooth alignment, tooth shape, tooth color, oral soft tissue and occlusal function in the observation group were higher than those in the control group (P <0.05). At 1 year after surgery,the masticatory efficiency and occlusal force of the observation group were higher than those of the control group (P <0.05). The satisfaction rate of the observation group (96.67%) was higher than that of the control group (83.33%) (P <0.05). Conclusion For maxillary impacted teeth, the combined treatment scheme of surgical guided eruption and orthodontics treatment can effectively improve clinical efficacy, aesthetic effect and masticatory function, and ultimately enhance patient satisfaction.