Objective. To explore the clinical effect and safety of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) combined with 1550 nm fractional laser therapy in the treatment of rosacea. Methods. 114 patients with type I and type II rosacea treated in our hospital from March 2018 to April 2020 were recruited. They were randomly assigned (1 : 1 : 1) to receive ALA-PDT (photodynamic group), 1550 nm fractional laser (laser group), or ALA-PDT and 1550 nm fractional laser therapy (combination group). Outcome measures included skin lesion scores, efficacy, and adverse reactions. Results. After treatment, patients in the three groups showed lower skin lesion scores than before treatment, and the combination group showed significantly lower results than the other groups (
P
<
0.05
). There was no significant difference in the total efficacy among the three groups (
P
>
0.05
), but the combination group outperformed the other groups in the comparison of the efficacy levels (
P
<
0.05
). Edema with lupus erythematosus, pain, and burning sensation was found in some cases but disappeared within 2 to 4 days after symptomatic treatment without interference with subsequent treatment. No patients had pigmentation, hypopigmentation, scars, or other serious adverse reactions. Conclusion. In the treatment of rosacea, ALA-PDT combined with a 1550 nm fractional laser can reduce redness and facilitate skin remodeling, with high efficacy and safety, so it is worthy of clinical promotion and application.