Objective To investigate the effect of multiple skin expansion on the efficacy and satisfaction of cicatricial plastic surgery after neck burn. Methods From February 2017 to March 2019, 60 patients with scar after neck burn were treated in our hospital. The patients were divided into 2 groups by random number table method, with 30 cases in each group. The control group received conventional flap repair, while the observation group received multiple skin expansion. The clinical efficacy, scar blood flow, pruritus, EGF, TNF-α, patient satisfaction and complications were compared between the two groups. Results The total effective rate of the observation group was 93.33%, which was higher than 73.33% of the control group (P<0.05). After operation, the blood flow value of scar and the score of pruritus in the two groups were significantly decreased, but the decrease of the observation group was more significant (P<0.05). After the operation, the EGF of the two groups increased significantly, but the increase was greater in the observation group. The TNF-α level of the two groups decreased significantly, but the decreasing range of the observation group was larger (P<0.05). The total satisfaction rate of the observation group was 90.00% (27/30), higher than 66.67% (20/30) of the control group (P<0.05). There were 3 cases (10.00%) in the observation group and 4 cases (13.33%) in the control group with no significant difference (P>0.05). The patients were followed up for 6 months after operation. Among them, 3 cases (10.00%) relapsed in the control group, and 1 case (3.33%) relapsed in the observation group. Conclusion The multiple expansion of skin can significantly improve the effect of scar plastic surgery, improve the blood perfusion and pruritus symptoms, increase EGF, reduce TNF-α level, and improve patients' satisfaction.