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PURPOSE: Till now the treatment of melasma is complicated and controversial.To search the possibility of duplicatable regimen using single laser treatment of melasma, in this study we designed Q-switched Nd:YAG 1064nm laser treatment.METHODS: 31 Chinese suffering from melasma were enrolled into this study.Q-swithed 1064nm Nd:YAG laser (MedLite_ C6; HOYA ConBio, CA, USA) was used as single method.Middle spot size of 4.0 mm, 4.5J/cm2 fluence with single pass treatment at 1-month interval was designed.24 sessions within two years were set up as terminal.Two treatment independent experienced doctors and patients were asked to assess the photographs and rate them on a scale from 0 to 4 (0: no improvement, 1: poor improvement, 2:mild improvement, 3: moderate improvement, 4: significant/excellent improvement).At the final control, all patients were asked to rate their satisfaction with the treatment outcome in five categories ranging from O to 4(0: not satisfied, 1: barely satisfied, 2: somewhat satisfied,3: satisfied, 4: very satisfied).MASI (Melasma Area and Severity Index) scores were evaluated by two experts at baseline and one month after the last treatment.RESULTS: The marked curative effects happened on the patients with malar regions, age of 40~50y, 21~22 sessions course, which got 3.29,3.35,3.57.Patient and doctor assessments levels following the QSNL procedure were generally correlated which was especially evident in patients with forehead lesions, Fitzpatrick skin type Ⅲ, 40~50y years old and with23~24 sessions treatment.About the patients satisfaction, 41.94%(13/31) got 4, 48.39%(15/31) got 3, 9.68%(3/31)got 2, no one was no satisfied, The average score is 3.32.The mean MASI scores at baseline and one month after post-treatmnent was lowered from 5.04 ± 4.32 to 1.71 ±2.10, which was a statistically significant change(P < 0.01).The most significant improvement was seen between baseline and post-treatment with the MASI score improving 56.45%.No case was founded punctuate leucoderma or hypopigmentation.All cases underwent transient pigmentation increase after 5~6 sessions, and began to sporadic pigmentation fade after another 5~6 sessions.CONCLUSION: The results indicate middle spot size of 4.0 mm, MedLite C6 Qswitched Nd:YAG 1064nm laser, at 4.5J/cm2 fluence, treatment is duplicatable effective and safe.Large case number group data and long terms follow up study is carried out to asses the further value of this regimen.