Background and Design: Acne scar is a complication of inflammatory acne due to damage to the skin. Various therapeutic modalities have been used for the treatment of acne scars. Among these treatments, minimal ablative fractional Erbium: yttrium-aluminum-garnet (Er: YAG) laser is a popular treatment modality for the improvement of acne scars. In this study, we retrospectively analysed the efficiency and tolerability of minimal ablative fractional Er: YAG laser therapy in the treatment of acne scars. Materials and Methods: Seventy-one patients with acne scars treated with minimal ablative fractional Er: YAG laser in our clinic between November 2011 and April 2013 were retrospectively evaluated. Treatment parameters, demographic features and before and after pictures of the lesions were investigated from patient records in order to evaluate the efficiency of Er: YAG laser therapy. Patients' photographs before and after treatment were compared. Clinical response was graded according to the percentage improvement. Side effects observed during the treatment and follow-up visits were evaluated from patient records. Results: Acne scar types included in the study were icepick (n=32, 45.1%), rolling (n=24, 33.9%), shallow boxed (n=7, 9.8%) and deep boxed (n=8, 11.2%). Clinical improvement rates evaluated as 1.4% minimal, 38.1% moderate, 47.8% good and 2.7% excellent. Adverse effects were 16.8% erythema that lasted more 3 days, 4.2% postinflammatory hyperpigmentation and 7.0% acne aggravation. Clinical improvement (3.2, good-excellent) and patient satisfaction rates (2.6, good-excellent) for icepick type scars were very high. Similarly, in shallow boxed scar types,
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