In this paper, an experimental protocol of adding rare earth lanthanum (La) was used to refine and modify inclusions (Al2O3) in aluminum-deoxidized steel. An optical microscope (OM), a scanning electron microscope (SEM), and an energy dispersive spectrometer (EDS) were used to study the impact of size distribution, number density, distribution uniformity, interfacial distance, area density, and so on of rare earth La on high-carbon hard wire steel inclusions. As indicated by the findings when the addition amount of La is 0.063%, the refining and homogenizing effect of Al2O3 inclusions in steel is the best. The average diameter of the inclusions is 1.75 μm, the uniformity is 0.84, the proportion of the interfacial spacing greater than 10 μm is 48.4%, and the area density of inclusions is set at 0.014. Based on classical thermodynamics and Factsage software, the effect of La activity on inclusion formation was computed. As indicated by the findings, the addition of rare earth La mainly combines with O and S in the liquid steel, and the La-containing inclusions wrap around the Al2O3 inclusions, hindering the Al2O3 inclusions. Through the evolution of inclusions during solidification, the modification of Al2O3 inclusions via rare earth La and the types of inclusions are discussed. The experimental results and theoretical calculations verify that the optimal treatment plan is to add 0.063% La.