Objective To investigate the effect of cast porcelain veneer restoration on aesthetic effect and restoration effect in patients undergoing oral aesthetic restoration. Methods A total of 50 patients who received oral aesthetic restoration in the Department of Stomatology, Huishan District People's Hospital from March 2023 to June 2024 were selected as the research subjects. According to the random number table method, they were divided into the control group and the study group, with 25 patients in each group. The control group received resin veneer restoration, and the study group received cast porcelain veneer restoration. The aesthetic effect, restoration effect and complication rate were compared between the two groups. Results The facial and intraoral scores in the study group after restoration were higher than those in the control group (P<0.05). The effective rates of color naturalness, marginal staining and marginal adaptation in the study group at 1 year after restoration were higher than those in the control group (P<0.05). The incidence of complications in the study group (4.00%) was lower than that in the control group (28.00%) (P<0.05). Conclusion In oral aesthetic restoration, the application of cast porcelain veneer can achieve satisfactory aesthetic effect and excellent clinical performance, with a low complication rate, leading to reliable overall restoration effect.