<p>An effective treatment strategy for pediatric hypertrophic burn scars has yet to be established. This study aimed to evaluate the efficacy and safety of a dynamic treatment approach that combines non-ablative fractional laser (NAFL) therapy with intralesional triamcinolone (TAC) injections for post-burn hypertrophic scars in children. Participants were assigned to three groups: the combination treatment group (22 patients), the laser-only group (19 patients), and the triamcinolone-only group (17 patients). After a 6-month follow-up period, all three groups demonstrated a significant decrease in the modified Vancouver Scar Scale (m-VSS) scores compared to their pre-treatment values, with the combination group experiencing the most substantial reduction. The median post-treatment m-VSS score in the combination group was significantly lower than in the laser-only and triamcinolone-only groups (5 vs. 7 vs. 9, <i>P</i> = 0.003). The obvious effective rate of combination group was 54.5%, significantly higher than that of laser group (26.3%) and injection group (23.5%) (<i>P</i> = 0.012). Combining non-ablative fractional laser therapy with intralesional triamcinolone injections is an effective and safe treatment for post-burn hypertrophic scars in children. This approach significantly alleviates pain and itching, resulting in high levels of satisfaction among both physicians and patients, warranting clinical recommendation.</p>