Objective:To explore the clinical effect of botulinum toxin type A combined with different parameters of CO2 frac-tional laser with different parameters on improving periorbital skin aging.Methods:A total of 108 patients with periorbital skin aging were enrolled as the research subjects.Both groups were given botulinum toxin type A combined with CO2 fractional laser.54 patients with parameters of 50 mJ and 8％were collected as group A,and 54 patients with parameters of 30 mJ and 4％were included in group B.The Global Aesthetic Improvement Scale(GAIS),skin images scores,skin barrier function,pain level[Visual Analogue Scale(VAS)]and incidence rates of complications were compared between groups.Results:At 6 months after treatment,the GAIS grading in group A was better than that in group B(P＜0.05).The skin images scores and transcutaneous water loss in both groups were lower than those before treatment(P＜0.05),and the indicators in group A were lower than those in group B(P＜0.05).The skin grease content and water content of stratum corneum were increased in both groups(P＜0.05),and the indicators in group A were higher than those in group B(P＜0.05).Immediately after treatment,the VAS score was higher in group A than that in group B(P＜0.05).There were no statistical differences in the incidence rates of complications between groups(P＞0.05).Conclusion:Botulinum toxin type A combined with 50 mJ,8％CO2 fractional laser can improve the overall cosmetic effect of patients,but the immediate postoperative pain level is higher.