Background: Striae distensae are a well-recognized, common skin condition that rarely causes any significant medical problems but are often a significant source of distress to those affected. The natural evolution of striae is from red or purple, raised wavy lesions (striae rubra) to white atrophic lesions with wrinkly surface (striae alba). Aim of the Work: was to compare the efficacy of the fractional CO2 laser in the treatment of striae rubra versus striae alba. Patients and Methods: The present study included 20 patients above the age of 18 of both sexes; 10 patients had striae rubra and 10 patients had striae alba. They were recruited from Dermatology outpatient clinic in Ain Shams University Hospital from June 2017 to January 2018. 4 sessions of Fractional CO2 Laser for each patient were performed one month apart. The treated striae were randomly selected from each patient (Striae rubra and alba) and were assessed before starting treatment, at the beginning of every session and one month after the last session as regards length, width, texture, color of striae and any complications encountered. Results: No significant difference was found on comparing the clinical response (improvement of color P= 0.653), (improvement of atrophy P= 0.606), side effects (Hyperpigmentation P= 0.531), (Pain P=0.606), (Hypopigmentation P=0.305), (Erythema P= 0.060), of both striae alba and rubra to the laser treatment. Conclusion: The present study showed significant clinical improvement in both types of striae distensae treated by Fractional CO2 Laser with non-significant difference between the 2 groups except the development of erythema in striae rubra group. Furthermore, the histological improvement was significant for both groups with low incidence of the side effects. Recommendations: Larger scale studies with longer follow up period are recommended to further clarify the role of fractional CO2 laser in treatment of striae distensae.