The Q-switched ruby laser has been demonstrated as an effective choice of treatment for a range of benign pigmented lesions. Its wavelength of 694 nm enables deep penetration of the skin allowing the treatment of both epidermal and dermal lesions. However, this wavelength is selectively absorbed by melanin thereby enabling efficient targeting of the lesion's melanocytes. By utilising a Q-switched pulsewidth of 25 nanoseconds, thermal conduction into surrounding tissues is minimised. Lesions such as nevus of Ota, chloasma, lentigines and cafe au lait have been successfully treated with energy densities ranging from 6 to 12 J/cm2. Four case histories are described in this report. The clinical evidence indicates that pigmented lesions in Chinese skin must be treated with energy densities higher than those used in Caucasian skin to minimise the incidence of hyper-pigmentation. Typically, lesions require a small number of treatments, usually within the range one to six, to effect complete removal. The technique is easy to apply, with no need for anaesthesia, in many cases.