Neurofibromatosis I (NF1) is an autosomal dominant disease that presents with multiple cutaneous lesions often numbering into the 500-1000 range. In addition to the psychosocial implications, there are limited surgical options for this condition. A series of 97 consecutive patients with NF1 presented with numerous cutaneous lesions. Treatment involved electrocautery excision of the lesions using a handheld device in one or more stages. This technique resulted in the removal of large numbers of lesions in limited stages, with minimal scarring, minor discomfort and high patient acceptance. For patients with NF1, single or multistage excision of cutaneous lesions using electrocautery produces an acceptable aesthetic result with high patient satisfaction.