Nonsurgical fat reduction has become a very popular cosmetic treatment category with energy-based devices demonstrating, in clinical trials, safety, and efficacy. These devices, which use both radiofrequency and cold, will be presented in this manuscript, and their documented efficacy will be reviewed. As well, the new field of high intensity focused electromagnetic technology is gaining excitement for not only muscle stimulation, but also for fat reduction and now skin tightening. And finally, pharmaceutical agents are being used and investigated for their clinical effects on reducing fat. The myriad of treatment options now available provide clinicians with great choices, with documented safety and efficacy, to reduce fat, tighten the skin, and stimulate muscle formation.