There are different modalities for management of atrophic acne scars which include lasers. Ablative fractional CO 2 laser was developed to address the shortcomings of traditional ablative lasers, with superior results to non-ablative fractional lasers. Autologous fat transfer has been utilized for nearly a decade in tissue augmentation and reconstruction. Present studies were designed to compare ablative fractional CO 2 laser treatment with scar subcision and autologous fat transfer in the treatment of atrophic acne scars. 20 patients with atrophic acne scars were recruited: 10 patients were treated by three sessions of ablative fractional CO 2 laser therapy, and 10 patients treated by subcision and autologous fat transfer. All patients were followed up for three months, and were assessed by digital photograph before and after treatment through the application of Goodman and Baron quantitative and qualitative grading systems, in addition to reports by three physicians committees and reports of patients' satisfaction. Analysis of both groups showed significant improvements in all types of atrophic acne scars. The mean percentage of total quantitative improvement was more significant in the case of autologous fat transfer with regard to ice-pick and total number of scars. Therefore, scar subcision with autologous fat transfer proved to be as effective as, or even more effective than, ablative fractional CO 2 laser in the treatment of atrophic acne scars with regard to the total number of scars as well as ice-pick type.Keywords: Acne scars; laser; fat transfer Citation: Mohammad LM, Elgarhy LH, Saad DG, Mostafa WA. Fractional ablative CO 2 laser treatment versus scar subcision and autologous fat transfer in the treatment of atrophic acne scars: New technique.