The present invention provides a visual fractional laser instrument, which comprises: an positioning cannula, the positioning cannula being a hollow tube with openings at both ends so as to locate a lesion site and define a path of the laser; a beam combiner component, the beam combiner component being a hollow tube with openings at both ends, and a side opening is provided on a side of the beam combiner component, wherein one end of the beam combiner component is connected to one end of the positioning cannula; a camera connected to the beam combiner component by the side opening to image the lesion site; a laser scanning component connected to another end of the beam combiner component for generating a laser beam used to scan the lesion site according to the image of the lesion site; and a control system connected to the laser scanning component and the camera, respectively. The visual fractional laser instrument is simple in operation, and the controlled laser beam automatically scans along a preset path and quickly burns castration pathological sites, thereby reducing operation time and surgeon workload, and increasing treatment efficiency and success rate.