Objective To explore the effect of apocrine gland trimming under direct vision through micro-linear incision in patients with axillary osmidrosis and its influence on operation-related indicators and incision healing. Methods A total of 82 patients with axillary osmidrosis admitted to the Department of Dermatology, Dazhou Integrated TCM&Western Medicine Hospital from September 2024 to July 2026 were selected, and they were divided into the control group and the observation group by the random number table method, with 41 patients in each group. The control group was treated with apocrine gland trimming under direct vision through micro-fusiform incision, and the observation group was treated with apocrine gland trimming under direct vision through micro-linear incision. The operation-related indicators, incision healing, clinical efficacy and complications were compared between the two groups. Results The operation duration and postoperative incision healing time in the observation group were shorter than those in the control group. The intraoperative blood loss was less than that in the control group (P <0.05). The primary healing rate of the observation group was 92.68%, which was higher than 75.61% of the control group (P <0.05). The total effective rate of treatment in the observation group (97.56%) was higher than that in the control group (92.68%), but the difference was not statistically significant (P >0.05). There was no statistically significant difference in the incidence of complications between the two groups (P >0.05). Conclusion Apocrine gland trimming under direct vision through micro-linearincision achieves favorable efficacy in the treatment of axillary osmidrosis. It helps to accelerate postoperative recovery and improve operation-related indicators, without increasing the risk of complications. It can be used as a preferred surgical method.