Objective: To investigate the effects of esketamine combined with sevoflurane on hemodynamics and pain in patients undergoing cervical and facial scar repair. Methods: 62 patients who underwent cervical and facial scar repair surgery in our hospital from February 2022 to February 2024 were selected as subjects. The patients were divided into control group and experimental group by random number table method, with 31 cases in each group. The control group was anesthetized with ketamine combined with propofol; The experimental group was anesthetized by esketamine combined with sevoflurane. The hemodynamics [mean arterial pressure, heart rate, respiration, oxygen saturation], pain degree [visual analogue (VAS) score], postoperative adverse phenomena and postoperative agitation of the two groups were analyzed and compared. Results: The mean arterial pressure, heart rate, respiration and oxygen saturation of the experimental group were significantly lower than those of the control group (P<0.05). The VAS scores of both groups at 4h and 24h after anesthesia were significantly lower than those immediately after anesthesia (P<0.05), and the VAS scores of the experimental group were significantly lower than those of the control group immediately after anesthesia, 4h and 24h after surgery (P<0.05). The incidence of respiratory depression, hypotension and postoperative delirium in the experimental group were significantly lower than those in the control group (P<0.05). The agitation rating of the experimental group was significantly lower than that of the control group (P<0.05). Conclusion: The use of esketamine combined with sevoflurane anesthesia for cervical and facial scar repair surgery can make the hemodynamic stability of patients, reduce postoperative pain, and reduce the occurrence of adverse phenomena and agitation.