Background: The aim of this study is to compare ablative CO 2 laser with fractional CO 2 laser on healing of the wound and the size of cutaneous leishmaniasis scars. Materials and Methods: This prospective randomized clinical trial study was done on 120 patients in two groups evaluated in Sedigheh Tahereh Hospital in Isfahan. The patients in case group underwent one session ablative CO 2 laser for treatment of leishmaniasis scars and the patients in control group underwent si x 3-weeks interval sessions fractional CO 2 laser for treatment of leishmaniasis scars. All cases were evaluated from size and other aspects of scar by a questionnaire, and before and 6 months after photos were evaluated by blinded dermatologist. The data collected in the check list was then analyzed by t-test and Chi-square with SPSS 20. Results: There were 60 people in case group and 60 in control group. The mean age was 27.21 ± 11.2. Our results show that fractional CO 2 laser is better than ablative CO 2 laser in various aspect of treatment of leishmaniasis scars (P < 0.05). Conclusions: Fractional CO 2 laser is better than ablative CO 2 laser in variants aspect of treatment of leishmaniasis scars.