The role of lasers and intense pulsed light sources has gained increasing popularity over the last decade. Major advances associated with improved results are the main reasons associated with this increasing popularity. These advances include epidermal cooling technologies, variable spot sizes and pulse durations as well as the ability to deliver high-energy fluences. These advances have allowed the delivery of sufficient energy to cause uniform pan-endothelial necrosis without affecting epidermal structures causing adverse sequelae such as post-inflammatory hyperpigmentation and epidermal surface irregularities. The advent of extended-pulse longer-wavelength technologies such as the 1064 Neodymium : Yttrium Aluminum Garnet (Nd : YAG) laser have allowed the treatment of individuals with darker phenotypic skin types as well as deep blue reticular veins up to 3mm in diameter in a monomodal fashion. Combined approaches of sclerotherapy plus laser treatments performed at the same treatment session may produce synergistic results in selected individuals.