To assess the efficacy and safety of low-energy QS Nd : YAG and QS alexandrite laser for melsasma.We treated 32 patients with melasma using the low-energy QS Nd : YAG and QS alexandrite laser. Pigment subsided by > or = 90% was regarded as "cured", by 60% -89% as "remarkably improved", by 30% -59% as "effective", and by < 30% as "ineffective" .Among the 32 patients, 21 patients (65.6%) were cured after (10.2 +/- 3.5) times (range: 4-15 times) of treatments, 11 patients (34.4%) were remarkably improved after (11.4 +/- 2.5) times (range: 10-14 times) of treatment. The rates of "cured" and "remarkably improved" were 81.3% and 18.7% among patients with light brown melasma and 50.0% and 50.0% among patients with dark brown melasma (P < 0.05). In patients with a disease history of less than 2 years, the rates of " cured" and "remarkably improved" were 87.5% and 12.5%, which was significantly better than the treatment results of patients with a disease history of more than 2 years (the rates of "cured" and "remarkably improved" were 58.3% and 41.7%) (P < 0.05). No hyperpigment and scarring was observed and only one patient experienced a transient pigment loss.Lower-energy QS Nd : YAG and QS Alexandrite Laser can be used to treat patients with melasma safely and effectively. The color and disease course of melasma were factors that may affect the treatment results.