This study is a retrospective case series conducted at Berkshire Medical Center and BCRSC approved by institutional review board exemption approval 45 CFR 46.104(d)(4). Written informed consent was obtained from patients electing to undergo PDL treatment for BCC at BCRSC. Inclusion criteria included any patients over the age of 18 with a biopsy-proven BCC who did not wish to proceed with surgical excision and who were poor surgical candidates for reasons of age, medical comorbidities, or immunosuppression. Exclusion criteria included recurrent or incompletely cleared lesions previously treated with PDL or surgical excision. Twenty patients with 21 biopsy-proven BCCs underwent two treatments with PDL at 6-week intervals. Laser parameters included 595 nm, one pass, 15 J/cm2 energy, 3 mc pulse length, and 7 mm spot size with 10% overlap. No cooling was used; instead the selected area for treatment was anesthetized with 1% lidocaine without epinephrine. Patients returned 6 weeks after the second treatment. The treated area was independently evaluated by two plastic surgeons for complete clinical response. If there was any discrepancy among surgeons or skin depigmentation, the area was biopsied and evaluated histologically for residual tumor. Follow-up examinations were conducted 6, 12, and 18 months after treatment with PDL.