Retinal laser photocoagulation is a proven, effective treatment for various retinal disorders, including diabetic retinopathy, retinal vein occlusions, and sickle cell retinopathy. To minimize iatrogenic retinal damage while maintaining therapeutic effects, retinal laser technology has evolved significantly since its introduction in ophthalmology more than half a century ago. These innovations have included both optimizations of laser parameters in addition to the development of novel laser delivery systems. This review summarizes recent innovations in retinal laser technology, including subthreshold micropulse laser, selective retinal therapy and nanosecond laser, innovative modes of laser delivery including pattern scanning laser, endpoint management, navigated laser, and newly described photo-mediated ultrasound therapy.