Acne is a common disease and patients frequently suffer from its distressing sequela of scarring which affects their quality of life. The treatment strategy for acne scars is usually influenced by multiple factors and we need to choose the best fit from amongst the various therapeutic modalities available. Lasers are increasingly being used and fractional ablative lasers create microthermal zones leading to collagen regeneration and reorganization in the target area. Fractional carbon dioxide laser has shown clinical efficacy in skin renewal in atrophic acne scars. Patient selection, counseling, pre, and postprocedure care guidelines form essential factors influencing the procedure outcomes. Here we discuss practical aspects of the use of fractional carbon dioxide laser in acne scar management along with pointers on patient selection, pre and postprocedure care, and side effects.