The spectrum of vascular skin changes includes a heterogeneous group of dermatological diseases. In addition to hemangiomas, port-wine stains, angiomas, spider naevi, and primary and secondary telangiectasias, which are considered classic indications for dermatological laser treatment, spider veins, poikiloderma of Civatte and venous malformations can also be the focus of dermatological and esthetic laser medicine. The argon laser which was so commonly utilized in the 80 s has been replaced by the pulsed dye laser. Furthermore, the long-pulsed KTP-Nd:YAG laser has become more widespread, as has the long-pulsed 1064nm-Nd:YAG laser in recent years. Diode lasers are currently being developed and will certainly have a role in the future. Copper vapor lasers, bromide lasers, and krypton lasers have not found standard use in Germany. In addition to vascular-specific lasers, intense pulsed-light (IPL) systems have established themselves well, although they will not be addressed in greater detail in this paper. The response of a skin change to one or more laser systems is generally a question of the skin type as well as the size and depth of the underlying vessels. Given correct diagnoses and indications, when correctly performed dermatological laser treatment is an effective treatment option with few side effects.