In the last decade, and-switched lasers have expanded the clinician's ability to treat decorative, cosmetic and traumatic tattoos without scarring. Previous methods of gross tissue removal with resultant scarring have been replaced by the highly selective removal of tattoo pigment with minimal changes in skin texture or pigmentation. This article reviews use of the Q-switched ruby, Q-switched neodymium-yttrium-aluminum-garnet and Q-switched alexandrite lasers in the clinical management of patients with tattoos.