Objective To analyze the clinical value of early drainage surgery in the therapy of acute pulpitis. Methods A total of 64 patients with acute pulpitis admitted to Jinjiang Municipal Hospital from March 2022 to August 2024 were selected as the study subjects. The 64 patients were random number table method divided into two groups for treatment, 32 cases in each group: the control group received pulp preservation therapy, and the observation group received early pulp decompression and drainage surgery. The treatment effects of the two groups were calculated. Results The total effective rate of the observation group was obvious higher, while inflammation indicators, bacterial colonies, pain scores, and oral health indicators were all lower, and the difference was statistically significant (P<0.05). Comparison of complications between the two groups, the difference was not statistically significant (P>0.05). Conclusions For the clinical treatment of acute pulpitis, early pulp decompression and drainage surgery can better control the inflammatory response, reduce bacterial count, and ultimately alleviate patient pain with high safety.