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BACKGROUND: The treatment of skin scars is a long-term focus and difficulty for plastic surgery and burn. Ultrasound has become a hot spot and trend in its scientific research due to its advantages of small trauma, fast recovery and low risk of scar treatment. OBJECTIVE: To explore the therapeutic effect of different intensities of ultrasound on abdominal skin scar in rabbits and its mechanism of action. METHODS: Sixteen 3-month-old New Zealand rabbits were selected and divided into four groups with four rabbits in each group, male and female, according to stratified random sampling method. After 21 days, sham ultrasound intervention was performed on abdominal scars in the sham ultrasound group, and 0.3, 0.5, and 0.8 W/cm2 ultrasound interventions were given to abdominal scars in the low-, medium- and high-intensity ultrasound groups, respectively, for 7 day each, for a total of two sessions with an interval of 2 days. The length and thickness of scars were measured before and after treatment. The area density of type I and III collagen in scar tissue after intervention was observed by Sirius red staining. The expression of serum N-terminal peptide of type III procollagen (PIIINP) was detected by ELISA before and after the intervention. RESULTS AND CONCLUSION: A total of 70 skin scars formed in 96 wound incisions, and the success rate of modeling was about 72.9%. After the intervention, the scar length in the low- and medium-intensity groups was significantly lower than that in the sham ultrasound group and the high-intensity group (P < 0.05). After the intervention, the scar thickness in the low-, medium- and high-intensity groups was significantly lower than that in the sham ultrasound group (P < 0.05). The scar thickness in the low-intensity group was significantly lower than that in the medium- and high-intensity groups (P < 0.05). After the intervention, the percentage of type I and III collagen in the low-intensity group was significantly higher than that in the high-intensity group (P < 0.05); the percentage of type I and III collagen in the high-intensity group was significantly lower than that in the sham ultrasound group (P < 0.05). After the intervention, the density ratio of type I/III collagen in the low-intensity group was significantly lower than that in the high-intensity group (P < 0.05). The difference of serum PIIINP expression before the intervention and after the first session was significantly lower in the low-, medium-, and high-intensity groups than the sham ultrasound group (P < 0.05), while the difference in the low-intensity group was lower than that in the medium- and high-intensity groups but with no statistical significance (P > 0.05). There was no significant difference between the two groups in the expression of serum PIIINP at the end of the first session and the end of the second session (P > 0.05). To conclude, low-intensity ultrasonic intervention has a better comprehensive effect on the treatment of hypertrophic scar. The mechanism of ultrasonic treatment may be to optimize the compliance of hypertrophic scar tissue through the mechanical, and physicochemica action on the arrangement of type I and III collagen fiber bundles in hypertrophic scar tissue, which still needs further research and confirmation. [ABSTRACT FROM AUTHOR]