Objective To explore the effect of intralesional glucocorticoid injection combined with intense pulsed light on scar improvement in patients with hypertrophic scar. Methods A total of 72 patients with hypertrophic scar admitted to our hospital from June 2024 to March 2025 were selected, and they were divided into the control group (n =36) and the experimental group (n =36) by the random number table method. The control group was treated with intralesional glucocorticoid injection alone, and the experimental group was treated with intralesional glucocorticoid injection combined with intense pulsed light. The clinical efficacy, scar improvement and scar status were compared between the two groups. Results The total effective rate of the experimental group was 91.67%, which was higher than 69.44% of the control group, and the difference was statistically significant (P <0.05). After treatment, the scores of flexibility, pruritus, pain and paresthesia in the experimental group were better than those in the control group, and the differences were statistically significant (P <0.05). After treatment, the scores of color, vascular distribution, thickness and softness in the experimental group were better than those in the control group, and the differences were statistically significant (P <0.05). Conclusion Intralesional glucocorticoid injection combined with intense pulsed light can effectively improve the clinical symptoms of patients with hypertrophic scar, promote the recovery of scar color, vascular distribution, thickness and softness, and has a good clinical effect, which is worthy of clinical application.