Objective To investigate the effect of 585 nm/1064 nm dual-wavelength combined laser on scar severity and subjective symptoms in patients with postoperative scars. Methods A total of 80 patients with postoperative scars treated in the Department of Dermatology, the Second Affiliated Hospital of Nanjing Medical University from January 2024 to December 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 40 patients in each group. The control group was treated with conventional topical silicone gel, and the observation group was treated with 585 nm/1064 nm dual-wavelength combined laser. The scar severity, subjective symptoms (pruritus and pain), patient satisfaction and adverse reaction rate were compared between the two groups. Results After treatment, the total score of modified Vancouver Scar Scale (mVSS) and the scores of pigmentation, vascularity, thickness and pliability in the observation group were lower than those in the control group (P <0.05). The VAS scores of pruritus and pain in the observation group were lower than those in the control group (P <0.05). The patient satisfaction in the observation group was higher than that in the control group (P <0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion Early intervention with 585 nm/1064 nm dual-wavelength combined laser for postoperative scars can effectively improve scar pigmentation, thickness and uncomfortable symptoms, with favorable safety and high patient satisfaction.