Objective To explore the effect of cosmetic suture on inflammatory indicators and aesthetic effect in patients with eyelid and periorbital soft tissue trauma. Methods A total of 40 patients with eyelid and periorbital soft tissue trauma admitted to our hospital from January 2016 to January 2025 were selected. According to different treatment schemes, they were divided into the control group and the study group, with 20 patients in each group. The control group was treated with debridement and anti-infection, and the study group was treated with cosmetic suture. The inflammatory indicators, aesthetic effect, complication rate and satisfaction were compared between the two groups. Results The levels of IL-6 and TNF-α in the study group at 2 weeks after treatment were lower than those in the control group (P <0.05). The scores of each item of aesthetic effect in the study group at 2 weeks after treatment were higher than those in the control group (P <0.05). The incidence of complications in the study group (0) was lower than that in the control group (10.00%), but the difference was not statistically significant (P >0.05). The satisfaction rate of the study group (100.00%) was higher than that of the control group (80.00%) (P <0.05). Conclusion Cosmetic suture has a good effect in the treatment of patients with eyelid and periorbital soft tissue trauma. It can effectively reduce inflammatory response, improve aesthetic effect, and will not increase the risk of adverse reactions, which is conducive to improving patient satisfaction.