Background and Objectives: High quality IPLs can offer simple, safe and effective treatments for long-term hair removal, removal of benign vascular and pigmented skin abnormalities, skin rejuvenation and acne treatments. Significant differences in clinical outcome have been recorded among different free-discharge and constant current IPLs despite identical settings. We investigated the differences in optical output of 19 IPLs in normal clinical use in the UK to evaluate spectral output, energy density values and pulse structure and propose a correlation between light-tissue interaction and spectral output as measured by time-resolved photo-spectrometry. Study Design/Materials and Methods: Using a fast spectrometer, generating 1,000 full spectral scans per second, time resolved spectral data of IPL outputs was captured with a resolution of 0.035 nm. IPL spectral outputs were calculated and graphically modelled using MathCAD TM software for comparison. Results: Several IPLs, which professed matching of pulse durations to the thermal relaxation times of specific follicular or vascular targets were shown to have effective pulse durations that were vastly shorter than those claimed. Some IPLs claiming 'square pulse' characteristics failed to show constant spectral output across the duration of the pulse or sub-pulses. Conclusions: This study provides a suitable method to determine accurately key parameters of the emitted light pulses from IPLs and confirms the direct correlation between the electrical discharge current profile and the output energy profile. The differences measured between first generation free discharge systems and modern square pulse systems may have important clinical consequences in terms of different light-tissue interactions and hence clinical efficacy and safety. IPL manufacturers should provide time-resolved spectroscopy graphs to users. Lasers Surg. Med. 40:83-92, 2008.