This chapter deals with surgical management of acne scars. Numerous invasive, semi-invasive and noninvasive techniques have been used to remove, replace or raise acne scars, and in turn resurface the cutaneous surface and reduce shadows. The currently available treatments for acne scarring include aesthetic approach, surgical approach and laser resurfacing. The treatment of postacne scars is a multimodality approach and any single modality usually does not bring satisfactory correction. Each modality has its advantages and disadvantages. The main goal of treatment is to achieve maximal improvement rather than perfection in most of the cases. The specific surgical techniques for management of postacne scarring include microneedling, subcision, punch techniques, trichloroacetic acid chemical reconstruction of skin scars and dermal grafting, which are discussed in detail in this chapter.