Objective In order to investigate the therapeutic effects of the mesotherapy with tranexamic acid assisted fractional laser in the treatment of rosacea.Methods Eighty-two patients with rosacea from our outpatient clinic between June 2019 and March 2022 were divided into laser group(40 cases)and combined group(42 cases)according to treatment modality.The erythema area,erythema index,and skin condition of both groups were compared before and after treatment.And the clinical efficacy and adverse effects of both groups were compared after treatment.Results After treatment,the erythema area of the combined group was smaller than that of the laser group[(39.45±7.36)mm2 vs.(50.24±6.15)mm2],and the erythema index,transepidermal water loss(TEWL),and Lactic Acid Sting Test(LAST)score of the combined group were lower than those of the laser group,respectively[erythema index:(0.98±0.14)vs.(1.37±0.25),TEWL:(9.96±2.33)g/(m2·h)vs.(13.02±2.28)g/(m2·h),LAST:(0.91±0.14)min vs.(1.43±0.29)min](all P<0.05).The total clinical efficacy rate of the combined group was higher than that of the laser group(95.24%vs.80.00%,P<0.05).There were no significant statistically differences in the incidence of transient flushing,local cutaneous redness,pigmentation and slight swelling between laser group and combined group(P>0.05).Conclusion The use of mesotherapy with tranexamic acid assisted fractional laser in the treatment of rosacea can improve the therapeutic effect as well as the cutaneous conditions of patients,and is a safe treatment option with high safety.