Objective: To investigate the efficacy of narrowband medium-wave ultraviolet (311nm) and excimer light (308nm) in treating vitiligo and their impact on patients" skin aesthetics. Methods:A total of 78 vitiligo patients admitted to our hospital from September 2024 to February 2026 were selected as the study subjects and randomly divided into an observation group and a control group,n=39. The control group received narrowband medium-wave ultraviolet (311nm) therapy, while the observation group was treated with excimer light (308nm). Results: The total effective rate in the observation group was higher than that in the control group (P<0.05). The onset time of repigmentation in the observation group was shorter, and the improvement rate of lesion area was higher than that in the control group (P<0.05). The levels of IL-17, TNF-α, and IFN-γin the observation group were lower than group control (P<0.05). The score of the self-assessment vitiligo skin aesthetic evaluation scale in the observation group was higher than that in the control group (P<0.05). Conclusion: Excimer light (308nm) therapy demonstrates superior efficacy in treating vitiligo, accelerates pigmentation recovery, suppresses inflammatory factor expression, enhances skin aesthetics, and reduces the incidence of adverse reactions during treatment.