BACKGROUND Several laser techniques have been proposed for the removal of decorative tattoos. The lasers that have been used most successfully are Q-switched red or near-infrared systems because of their ability to target tattoo pigment selectively with minimal risk of scarring or permanent pigmentary changes. OBJECTIVE The objectives of this study were to determine the clinical effectiveness of the newest Q-switched system, the alexandrite laser, in removing amateur and professional tattoos and to observe side effects. METHODS Twenty-four multicolored professional tattoos and 18 blue-black amateur tattoos were treated with the Q-switched alexandrite laser (755 nm, 100 nsec) at 2-month intervals until total clearing was achieved. The 510 nm pulsed dye laser was used to treat tattoos that contained red pigment. RESULTS Professional tattoos required an average of 8.5 alexandrite laser treatments for total clearance, whereas only 4.6 treatments were necessary to remove amateur tattoos. Red tattoo pigment was successfully treated with an average of two 510 nm pulsed dye laser sessions. No scarring or long-standing pigmentary changes were seen in laser-irradiated skin. CONCLUSIONS The Q-switched alexandrite laser is highly effective in removing multicolored professional and amateur tattoos without adverse sequelae. The 510 nm pulsed dye laser was useful in eliminating red tattoo pigment.