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BACKGROUND: Successful treatment of acne scars is challenging. Many modalities have been used with marginal success. OBJECTIVE: The authors describe a combination of a superficial chemical peel, subcision, and fractional carbon dioxide (CO2) laser resurfacing in a single-treatment session as a novel treatment approach for rolling acne scars. METHODS: A total of 114 patients (75 women and 39 men) with predominantly rolling acne scars were treated with a 20% trichloracetic acid chemical peel, subcision with a novel dissecting instrument, and the CO2 laser under tumescent anesthesia. This was a retrospective, uncontrolled, unblinded study. RESULTS: The mean improvement after a single treatment was 2.9 on a scale of 1 to 4 with few complications. Ninety percent of the patients were satisfied with their final result and desired no additional treatment. CONCLUSION: The combination of a trichloracetic acid 20% chemical peel, subcision, and fractional CO2 laser resurfacing combined with tumescent anesthesia is both safe and effective in the treatment of rolling acne scars. [ABSTRACT FROM AUTHOR]