With the growing social demand for minimally-invasive aesthetics, techniques for facial rejuvenation and wrinkle removal are continuously innovated. Integrating the essence of traditional TCM acupuncture theory and modern minimally-invasive surgery, the blade needle minimally invasive technique has been increasingly applied in this field owing to its advantages of slight trauma, rapid recovery and precise operative layers. It exerts anti-wrinkle effects by releasing fascial adhesions, stimulating collagen regeneration and regulating local microcirculation, and certain practical experience has been accumulated in clinical intervention for dynamic and static wrinkles. Nevertheless, many issues remain to be solved regarding in-depth interpretation of its mechanism, evidence-based evaluation of long-term efficacy, and optimized strategies for combined application with mainstream therapies such as botulinum toxin injection and thread lifting. This paper systematically reviews the mechanism and operational specifications of blade needle minimally-invasive technique, assesses evidence for its efficacy and safety, summarizes its combined-therapy patterns and research advances, and discusses future research directions and challenges, so as to provide scientific basis for clinical practice.