Objective To explore the effect of intrascar release surgery combined with fractional carbon dioxide (CO2) laser on skin texture and depression improvement in patients with facial depressed scar. Methods A total of 51 patients with facial depressed scar admitted to the Department of Plastic Surgery, Aoyang Hospital Afffliated to Jiangsu University from March 2021 to January 2025 were selected. According to the random number table method, they were divided into the control group (n=25) and the study group (n=26). The control group was treated with fractional CO2 laser, and the study group was treated with intrascar release surgery combined with fractional CO2 laser. The improvement of skin texture and depression, scar condition, satisfaction and adverse reaction rate were compared between the two groups. Results At 6 months after treatment, the reduction value of depression depth and the skin surface smoothness in the study group were higher than those in the control group (P<0.05). At 3 and 6 months after treatment, the scores of VSS in the study group were all lower than those in the control group (P<0.05). The satisfaction rate of the study group (92.31%) was higher than that of the control group (76.00%) (P<0.05). There was no statistically signiffcant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Intrascar release surgery combined with fractional CO2 laser can effectively improve skin texture and depression, enhance the overall repair effect of facial depressed scar, and increase patient satisfaction, with good safety.