A laser optical projection module and a wearable device are provided. The laser optical projection module includes a laser beam scanning device, a first optical lens assembly on a side of the laser beam scanning device, and a microlens array. The laser beam scanning device has a laser light source and a micro-electro-mechanical micromirror. A laser beam emitted from the laser light source is reflected and projected by the swinging micro-electro-mechanical micromirror. Light spots of the laser beam emitted from the laser beam scanning device are reduced by the first optical lens assembly, and a pitch between the light spots is decreased. The microlens array having microlenses is configured on a side of the first optical lens assembly and on a projecting direction of the laser beam. A uniform imaging image formed by uniform and parallel imaging lights is obtained after the laser beam passes through the microlenses.