Objective To explore the effect of anatomical repair surgery on lip aesthetics in patients with lip laceration. Methods A total of 80 patients with lip laceration admitted to the Department of Emergency Medicine, Trauma Center,the Fifth People's Hospital of Zhuhai from February 2022 to February 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 40 patients in each group. The control group was treated with conventional debridement and suture surgery, and the observation group was treated with anatomical repair surgery. The repair effect, lip aesthetics and oral function were compared between the two groups. Results The postoperative repair effect of the observation group was better than that of the control group (P <0.05). The scores of symmetry, scar condition, lip shape and color, and overall coordination of the observation group after surgery were higher than those of the control group (P <0.05). The OHIP- 14 score of the observation group at 1 month after surgery was higher than that of the control group (P <0.05). Conclusion I n the treatment of lip lacerations, anatomical repair surgery can effectively promote tissue healing, restore basic oral function, and improve lip appearance, thereby achieving simultaneous improvement in repair effect, functionality and aesthetics.