Objective To analyze the effect of fractional CO2 laser combined with moist exposed burn ointment on wound pain intensity and scar hypertrophy in patients with hypertrophic scar. Methods A total of 100 patients with hypertrophic scar admitted to Longyan First Hospital from January 2022 to December 2024 were selected. According to the random number table method, they were divided into the control group and the observation group, with 50 patients in each group. The control group was treated with fractional CO2 laser, and the observation group was treated with fractional CO2 laser combined with moist exposed burn ointment. The wound pain intensity, scar hypertrophy, time to complete epithelialization of wounds and adverse reaction rate were compared between the two groups. Results At 4.5 months after treatment, the scores of VAS and VSS in the observation group were all lower than those in the control group (P<0.05). The time to complete epithelialization of wounds in the observation group was shorter than that in the control group (P<0.05). The incidence of adverse reactions in the observation group (2.00%) was lower than that in the control group (10.00%) (P<0.05). Conclusion The combination therapy of fractional CO2 laser and moist exposed burn ointment for patients with hypertrophic scar can not only alleviate wound pain intensity, but also improve scar hypertrophy, accelerate wound recovery, and reduce the incidence of adverse reactions.