Objective To explore the effect of endoscopic latissimus dorsi myocutaneous flap breast reconstruction on breast aesthetic effect in patients with Poland syndrome. Methods A total of 68 female patients with Poland syndrome admitted to our hospital from January to December 2024 were selected, and they were divided into the control group and the observation group by the random number table method, with 34 patients in each group. The control group received traditional latissimus dorsi myocutaneous flap breast reconstruction, and the observation group received endoscopic latissimus dorsi myocutaneous flap breast reconstruction. The surgery-related indicators, breast aesthetic effect and quality of life were compared between the two groups. Results The surgery-related indicators of the observation group were all better than those of the control group (P<0.05). The excellent and good rate of the observation group at 6 months after surgery (97.06%) was higher than that of the control group (79.41%) (P<0.05). The scores of all dimensions of quality of life in the observation group at 6 months after surgery were all higher than those in the control group (P<0.05). Conclusion Endoscopic latissimus dorsi myocutaneous flap breast reconstruction can shorten the operation time, postoperative extubation time and postoperative pain duration of patients with Poland syndrome, and reduce the intraoperative blood loss and total postoperative drainage volume. Meanwhile, it can achieve better postoperative breast aesthetic effect and improve quality of life.