Epidermoid cyst (EC) is a slowly growing benign cutaneous tumor, typically manifesting as a well-demarcated, skin-colored to yellowish dermal nodule. Histologically, the cysts are lined by stratified epithelium and filled with keratinous mass. They may occur anywhere on the body, most commonly on the face, scalp, neck, chest, and upper back. Patients of any age or gender might be involved. 1 Secondary infection and inflammation may occur, especially when the cyst wall ruptured. 2 Malignant transformation of EC is rare but possible. Squamous cell carcinoma, basal cell carcinoma, and Merkel cell carcinoma have been reported arising from EC. [3][4][5][6] Many patients require intervention due to health or cosmetic considerations.Surgical excision is a typical approach for the treatment of EC, while keloid formation and linear scarring are common side effects. 7,8 Therefore, several minimally invasive procedures for EC removal have been introduced, such as punch excision and laser drainage. 1,[7][8][9][10][11][12][13] Only a few researches have been reported on EC treated by carbon dioxide (CO 2 ) laser, in which the cyst diameters or locations were restricted. 7,11 Our study has a larger sample size, no limitation on the location or original size of cysts, and aims to evaluate the efficacy and safety of EC removal with CO 2 laser fenestration.