To meet the need for the high-precision contactless measurement of the freeform surface profile during the manufacturing, we propose a high-precision measurement method that combines the laser differential confocal trigger sensor (LDCTS) and the real-time comparison method using reference planes (RCMRP). LDCTS is used to measure the freeform surface under test (FSUT), which enables the high-precision measurement of the surface profile with the large roughness and local inclination. Through the real-time comparisons of the coordinate changes of the reference planes and FSUT, the dominant straightness and rotation errors can be separated based on the error model and thus the spatial motion errors can be significantly reduced along all three axes. Combing these two strategies, we find that the inclination measurement capacity becomes larger than 25° and the repeated measurement accuracy is improved to be better than 10 nm within the horizontal scanning range of 150 mm × 150 mm. Compared with the non-RCMRP method, the repeated measurement accuracy is improved by at least 5 times. We believe the proposed method provides a strategy for the high-precision measurement of freeform surface profile with large local inclination and roughness during different manufacturing periods.