Objective To investigate the clinical effect of ultra-pulsed CO2 dot matrix laser combined with narrow-spectrum intense pulsed light in the treatment of scar after secondary cleft lip reconstruction. Methods A total of 82 patients receiving second-stage nasolabial deformity reconstruction after cleft lip surgery in Zhengzhou First People"s Hospital were included in this study, and the selected time was from March 2021 to March 2024. According to different treatment methods, they were divided into control group (41 cases, treated by super-pulse CO2 dot-matrix laser) and study group (41 cases, Combined treatment with ultra-pulsed CO2 lattice laser and narrow-spectrum intense pulsed light). Vancouver Scar Scale (VSS) scores, treatment satisfaction, and adverse reactions were compared between the two groups before treatment, after the last treatment, 4 months and 6 months after surgery, and pictures of typical cases before and after treatment were analyzed. Results Compared with before treatment, VSS scores in both groups decreased from the last treatment to 6 months after surgery, and the above scores in the study group were lower than those in the control group (t=8.782, 13.661, 8.655, all P<0.05). The very satisfaction rate and willingness rate of the study group were higher than those of the control group (χ2=9.725, 15.449, P<0.05). No adverse reactions such as erythema and edema were observed in the control group, while only 1 case of transient pigmentation was observed in the study group. There was no significant difference in the overall incidence of adverse reactions between the two groups (χ2=0.000, P>0.05). Conclusion The combination of ultra-pulsed CO2 dot array laser and narrow-spectrum intense pulsed light in the treatment of scar after the second stage of cleft lip reconstruction can reduce the VSS score, and does not increase the occurrence of adverse reactions, with good safety, high satisfaction of patients" families, and accurate efficacy.