Melasma is a common acquired pigmented dermatosis prevalent in Asian populations, characterized by facial symmetrical light-brown patches. Its pathogenesis involves multiple factors including abnormal melanin metabolism, basement membrane zone damage, angiogenesis and inflammatory response. Clinical treatment faces challenges such as high recurrence rate and unstable therapeutic efficacy. As a novel technology integrating minimally invasive permeation enhancement and tissue repair functions, microneedling therapy constructs mechanical microchannels and stimulates skin regeneration, which provides a new solution for melasma treatment. Based on the latest clinical evidence and expert consensus, this paper systematically reviews the mechanism of action, common technical types and clinical application protocols of microneedling therapy for melasma, aiming to provide a reference for its standardized clinical application.