This chapter gives an overview on scar refinement. In addition to poor cosmesis, scarring can cause psychosocial distress and impact quality of life. Scars are not only unappealing but can also be painful, pruritic, and limit mobility causing significant discomfort for the patient. Surgical scars may take months to years to mature and can often show improvement without any intervention. In addition to deciding what scar treatment to use, another important question is when to intervene. In most cases, it is best to treat the scar prior to its maturity. Early intervention, even as early as the time of suture removal, is often the best practice. Scar refinement can require multiple treatments and setting patient expectations is crucial to the process. Laser treatments, dermabrasion, subcision, intralesional injections, pressure, radiation, and re-excision are various treatment modalities discussed in this chapter, which are often used in combination or succession to get the best clinical outcome.