Objective To analyze the effect of acupoint acupuncture on facial aesthetics and skin elasticity in patients with facial aging. Methods A total of 80 patients with facial aging who visited the Department of Traditional Chinese Medicine, Wuzhong District Xukou Town Health Center from June 2023 to May 2025 were selected, and they were divided into the reference group and the analysis group by the random number table method, with 40 patients in each group. The reference group was treated with medical sodium hyaluronate repair patch, and the analysis group was treated with acupoint acupuncture. The facial aesthetics, skin elasticity, adverse reaction rate and wrinkle severity were compared between the two groups. Results At 3 months after treatment, the scores of facial fullness, appearance aesthetics and skin ffrmness in the analysis group were higher than those in the reference group (P<0.05). At 3 months after treatment, the skin elasticity of the corner of the mouth, upper and lower lips, and nasolabial fold in the analysis group was better than that in the reference group (P<0.05). There was no statistically signiffcant difference in the incidence of adverse reactions between the two groups (P>0.05). The grades of wrinkle severity rating scale in the analysis group were lower than those in the reference group both immediately and at 3 months after treatment (P<0.05). Conclusion For patients with facial aging, the application of acupoint acupuncture can improve their skin elasticity and facial aesthetics, reduce the severity of wrinkles, and help to reduce the incidence of adverse reactions.