CO2 laser has been used for the treatment of 22 patients with xanthelasma palpebrarum. This office procedure done under local anesthesia is fast and easy. The lipomatous yellow plaques are accurately photovaporized in a bloodless field, layer by layer, until the lesion is totally eradicated. The treated area heals by reepithelization, ostensibly with virtually no scar contraction. All our patients were satisfied with their results, rating them from good to excellent. In 5 patients some pigmentation changes were noted. During follow-up periods varying from 15 to 54 months, only 2 (9%) patients had recurrences, which were retreated successfully. We postulate that treatment of xanthelasma palpebrarum by CO2 laser should be seriously considered in most patients.