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Objectives: Our objective was to determine the safety and efficacy of combining photo acoustic and thermal treatment for skin rejuvenation. Introduction: Skin aging is influenced by multiple genetic and environmental factors that can manifest in the form of wrinkles, pigmentation, skin laxity. Skin rejuvenation is effectively treated by ablative laser proceduresbut at the price of patient discomfort, substantial downtime, and adverse events.Alternative treatments using non-ablative fractionated laser are increasingly preferred due to their minimal down-time.But no study compared the effect of combining the photoacoustic and photothermal effect for skin rejuvenation vs the photothermal effect alone. Materials / method: Patients with mild to moderate facial aging who were treated in our clinic for facial rejuvenation were decided into 2 groupd. Group A received nonfractional microsecond pulsed ND:YAG laser, Group B received both Q-switched ND:YAG laser and nonfictional microsecond pulsed ND:YAG laser. Standardized high-resolution digital photography of the treatment area was performed for each patient at baseline, before each treatment, on each visit, and at the 2-month follow-up visit, as well as a digital scan using a novel 3D skin vision imaging platform for evaluation and grading. Results: Twenty one female patients’ ages 44-67 (mean 55 years) completed the treatment and follow-up period, in both groups.Group A showed an overall mild improvement in facial wrinkle surface area (mean improvement of 18% ), as well as a mild improvement in overall pores surface area. Whereas Group B showed a mild-moderate improvement in facial wrinkle surface area ( mean improvement of 27%), with a great improvement in pores depth and surface area. Patient satisfaction was much higher in Group B. Conclusion: The combination of the QSF-Nd:YAG laser and non-fractional microsec- ond pulsed technology, using a single Nd:YAG 1064 nm laser platform, was found safe and effective as a non-ablative modality for facial rejuvenation, as demonstrated by a novel 3D imaging modality.