Objective To investigate the efffcacy and safety of low-level laser combined with nano microneedle in patients with androgenetic alopecia (AGA). Methods A total of 40 patients with AGA admitted to our hospital from January to October 2025 were selected, and they were divided into the control group and the observation group according to different treatment regimens, with 20 patients in each group. The control group received comprehensive treatment with oral and topical medications, and the observation group received low-level laser combined with nano microneedle on the basis of the control group. The clinical efffcacy, trichoscopic indicators and adverse reaction rate were compared between the two groups. Results The total effective rate of the observation group was 100.00%, which was higher than 80.00% of the control group (P<0.05). The hair density, scalp oiliness and hair diameter in the observation group after treatment were better than those in the control group (P<0.05). The incidence of adverse reactions in the observation group was 5.00%, which was lower than 30.00% in the control group (P<0.05). Conclusion Low-level laser combined with nano microneedle is effective in the treatment of AGA. It can promote hair growth and improve scalp oil secretion, with a low incidence of adverse reactions and high efffcacy and safety.