Low-energy laser irradiation has positive effects on bone fracture healing, osteoblast proliferation, bone nodule formation, and alkaline phosphatase activity. However, the mechanism by which low-energy laser irradiation affects bone is not clearly known. It was recently found that light at a low radiation dosage is absorbed by intracellular chromophores. High-intensity pulsed laser irradiation can produce acoustic waves in the target surface by rapidly heating the tissue. We considered that the acoustic waves induced by high-intensity pulsed laser irradiation, in addition to the photochemical effects that are induced, accelerate bone formation. To clarify whether high-intensity pulsed laser irradiation accelerates bone formation, we investigated bone formation in the irradiated femur of rat, using histomorphometric analysis. Rat femurs were irradiated with a Q-switched Nd: YAG laser, which has a wavelength of 1064 nm, under two conditions: once a day, with the average fluence rate set at 100 mW/cm(2) (LA1), and twice a day, i.e., every 12 h, with the average fluence rate set at 50 mW/cm(2) (LA2). The mean bone volume and mineral apposition rate in the LA1 group were significantly higher than those in the nonirradiated group (control). These values were highest for the LA2 group, and were about 1.52 and 1.25-fold those of the control, respectively. These data demonstrated that the number of pulses, rather than the intensity of the laser irradiation, affects bone formation. Thus, this study indicated that high-intensity pulsed laser irradiation accelerates bone formation in the metaphysis. This bone formation induced by high-intensity pulsed laser irradiation might be due to laser-induced pressure waves.