Objective To explore the effect of micro-implant anchorage (MIA) combined with fixed orthodontics appliance on aesthetic effect in orthodontics patients. Methods A total of 80 patients who received orthodontics treatment in the Department of Stomatology, the Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai from January 2022 to August 2024 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 anchorage combined with fixed orthodontics appliance, and the observation group was treated with MIA combined with fixed orthodontics appliance. The aesthetic effect, root resorption volume, satisfaction and complication rate were compared between the two groups. Results The PES score of the observation group after treatment was higher than that of the control group (P <0.05). The root resorption volume of the observation group after treatment was lower than that of the control group (P <0.05). The satisfaction rate of the observation group (95.00%) was higher than that of the control group (72.50%) (P <0.05). There was no statistically significant difference in the incidence of complications between the two groups (P >0.05). Conclusion The treatment of MIA combined with fixed orthodontics appliance shows advantages in improving the aesthetic effect of anterior teeth, controlling root resorption volume, enhancing patient satisfaction and reducing the incidence of complications, with good clinical application safety.