Given the increasing demand for cosmetic surgery and its associated psychological consequences, the present study was conducted to investigate the effectiveness of schema therapy on body image, suicidal ideation, and psychological distress among cosmetic surgery applicants. The study employed a quasi-experimental pretest–posttest design with a control group. The statistical population consisted of all cosmetic surgery applicants who referred to Afra Counseling Center in Isfahan during the summer of 2024. A total of 30 participants were selected through convenience sampling and were randomly assigned to an experimental group and a control group, with 15 participants in each group. The experimental group participated in 12 sessions of schema therapy, each lasting 90 minutes and conducted twice a week, whereas the control group received no intervention. Data were collected using body image, suicidal ideation, and psychological distress questionnaires and were analyzed through multivariate and univariate analysis of covariance. The findings indicated that schema therapy improved body image and reduced suicidal ideation and psychological distress among cosmetic surgery applicants. Therefore, schema therapy was suggested as an effective intervention for modifying maladaptive cognitive-emotional patterns and promoting psychological well-being in this population.