Objective To explore the efffcacy of CO2 fractional laser with artiffcial lattice combined with drug injection and delicate pulsed light (DPL) in the treatment of hypertrophic scar. Methods A total of 60 patients with hypertrophic scar who were treated at Changshu No.5 People's Hospital from June 2022 to June 2024 were selected, and they were divided into Group A, group B, and group C by the random number table method, with 20 patients in each group. Group A was treated with compound betamethasone injection. Group B was treated with CO2 fractional laser with artiffcial lattice combined with compound betamethasone injection. Group C was treated with CO2 fractional laser with artiffcial lattice combined with compound betamethasone injection and DPL. The Patient and Observer Scar Assessment Scale (POSAS) score, pain and pruritus severity, and adverse reaction rate were compared among the three groups. Results At 3 months after treatment, the POSAS score of group C was lower than that of group A and group B (P<0.05). At 3 months after treatment, the scores of pain and pruritus in group C were lower than those in group B and group A (P<0.05). There was no statistically signiffcant difference in the incidence of adverse reactions among the three groups (P>0.05). Conclusion Compared with monotherapy and dual therapy, CO2 fractional laser with artiffcial lattice combined with drug injection and DPL can effectively ffatten and soften scar, improve the color and appearance of hypertrophic scar, alleviate pain and pruritus, without increasing the risk of adverse reactions, which is worthy of clinical application.