An imaging dot matrix laser treatment instrument, comprising: a locating insertion tube (1) comprising a hollow tube open at two ends, configured to locate a treatment region and define a laser beam path; a beam combiner lens component (2) comprising a hollow tube having openings at two ends thereof and a lateral opening arranged at a side thereof, wherein one end of the beam combiner lens component is connected to one end of the locating insertion tube (1); a camera head (3) connected to the beam combiner lens component (2) via the lateral opening to form an image of the treatment region; a laser scanning component connected to another end of the beam combiner lens component (2) to generate, according to the image of the treatment region, a laser beam scanning the treatment region; and a control system (4) connected to the laser scanning component and the camera head (3), respectively. The imaging dot matrix laser treatment instrument is simple in operation, reducing operation time and surgeon workload, and an increasing treatment efficiency and success rate.