Objective: Lasers have been used in otolaryngology as a surgical instrument for more than 25 years, and the CO 2 laser has emerged as the most widely employed surgical laser in use today. However, recent technological advances have made the Nd:YAG laser a challenger as an effective photothermal surgical tool. Study Design and Methods: This is a two-part study. Tissue injury and healing profiles after application of both the CO 2 and Nd:YAG lasers are compared using an in vivo rat tongue model. A prospective clinical review based on the experience of 327 operative cases spanning a 7-year interval using the Nd:YAG laser, highlighting its various applications and associated complications, is detailed. Results: Comparable tissue and healing effects were noted with both lasers in the in vivo rat tongue model with no statistical differences. The clinical application of the laser showed wide versatility in the head and neck with a complication rate of 3%. Conclusion: The Nd:YAG laser has proved equivalent in tissue damage and healing to the CO 2 laser. The Nd:YAG laser has proved itself to be an excellent and perhaps superior laser for use in head and neck surgery. Key Words: Nd:YAG laser, in vivo model, prospective review, head and neck.