Pigmented skin lesions were treated by a ruby laser with a wavelength of 694 nm and a pulse duration of 450 microseconds. The clinical result of laser treatment was good in 18 of the 55 cases (32%). Five of 21 cases (23.8%) with cafe-au-lait maculae, 9 of the 14 cases (64%) with senile pigmentation, and 3 of the 10 cases (30%) with nevocellular nevus had good results. The cafe-au-lait maculae showed excellent fading after laser treatment but the recurrence rate was high. The best therapeutic result was obtained in senile pigmentation.