Acne is a chronic inflammatory disease of pilosebaceous glands that affects approximately 85% of adolescents and young adults. Acne commonly presents on area which are rich in pilosebaceous glands like face, upper arm, trunk and back. Acne scars occur as a result of inflammatory process associated with acne vulgaris which leads to abnormal production and degradation of collagen during healing process. Acne scarring is a significant concern for many patients, as it can lead to psychological distress, reduced self-esteem and have negative impact on quality of life. This randomized comparative study evaluates the efficacy and safety of Fractional carbon dioxide (CO2), laser versus microneedling with Dermapen therapy in management of atrophic acne scars. Fifty-four patients with clinical diagnosis of atrophic acne scars were assigned to two treatment groups: Group A received treatment with Fractional carbon dioxide laser therapy, while Group B underwent treatment with microneedling with Dermapen. Each patient received three treatment sessions at four-week intervals with follow up till 12th week. The results demonstrate that both modalities reduce the severity of acne scars, however microneedling (Dermapen) demonstrated earlier and superior qualitative/patient-reported improvement compared to Fractional CO2 laser, with fewer side effects. Both treatments were effective over time, but microneedling may offer better tolerability and faster initial results.