Fractional photothermolysis has been the most remarkable breakthrough in clinical laser science since selective photothermolysis. Fractionated laser beams create microscopic wounds that reach greater dermal depths and promote a rapid healing effect. This method of skin resurfacing using a laser has led to clinical efficacy in aesthetic procedures and scar treatment with high physician and patient satisfaction. Fractional lasers have a better safety profile than traditional resurfacing techniques. Research over the last 8 years has improved our understanding of the clinical effects, histologic changes, molecular cascades, and risks associated with fractional laser resurfacing. Over the next 5 years, developments in fractional devices will be exciting as we continue to research and understand the potential of these devices. We will see more applications of fractional lasers in both aesthetic and medical procedures. The next frontier of fractional devices will be laser-assisted delivery systems using the channels to deliver drugs and other bioactive materials. Other light sources will be fractionated, and tunable, high-peak, power-variable pulse duration devices may enter the market.