Objective To observe the improvement effect of intralesional separation combined with carbon dioxide lattice laser on pigmentation and scar area in the treatment of facial depressed scars. Methods The clinical data of 76 patients with facial depressed scars from November 2020 to September 2023 were retrospectively analyzed. They were divided into a control group and an observation group with 38 cases in each group. The patients in the control group were treated with carbon dioxide lattice laser, while the patients in the observation group were treated with intra-scar separation combined with carbon dioxide lattice laser. The before-and-after pigmentation and scar area and incidence of complications of the two groups were compared. Results After treatment, the pigmentation and scar area of the observation group were smaller than those of the control group （P<0.05）; the difference in the incidence of complications between the two groups was not statistically significant （P>0.05）. Conclusion Intralesional separation combined with carbon dioxide lattice laser has a good effect in the treatment of facial depressed scars, which is superior to the treatment with carbon dioxide lattice laser alone. It can significantly reduce the facial pigmentation and scar area of patients, and does not significantly increase the incidence of complications.