Objective To investigate the effect of low-frequency pulsed electrical stimulation combined with orofacial sensorimotor training on facial symmetry and perioral contour aesthetic scores in patients with facial nerve injury. Methods The clinical data of 60 patients with facial nerve injury admitted to People’s Hospital of Ningxia Hui Autonomous Region from January 2023 to January 2025 were retrospectively analyzed. Patients were divided into the control group and the observation group according to different intervention regimens, with 30 patients in each group. The control group received orofacial sensorimotor training, and the observation group received low-frequency pulsed electrical stimulation combined with orofacial sensorimotor training. The facial symmetry, perioral contour aesthetic scores and surface electromyographic signal characteristics were compared between the two groups. Results The facial symmetry index of the two groups after intervention was higher than that before intervention, and that of the observation group was higher that of the control group (P <0.05). After intervention, the scores and total scores of perioral contour aesthetics in the two groups were higher than those before intervention, and those in the observation group were higher than those in the control group (P <0.05). The maximum amplitude in the two groups after intervention was higher than that before intervention, and that in the observation group was higher than that in the control group (P <0.05). The muscle contraction duration of the two groups after intervention was shorter than that before intervention, and that of the observation group was shorter thanthat of the control group (P <0.05). Conclusion Low-frequency pulsed electrical stimulation combined with orofacial sensorimotor training can effectively improve facial symmetry and perioral contour aesthetic scores in patients with facial nerve injury, enhance the electrophysiological activity of orofacial expressive muscles, and realize simultaneous improvement of functional rehabilitation and appearance aesthetics.