This 16.5 kDa protein is a member of the IAP gene family, which controls cell division, proliferation, and survival by inhibiting the apoptotic process. No detectable or only extremely low levels of survivin expression are present in normal tissues; on the other hand it is present at comparatively larger levels in certain malignant tissues, embryonic and foetus tissues, as well as in only few adults and some of their normal tissues, such as their skin. Antitumour, antibiotic, and antiviral properties are all present in the cytotoxic substance, bleomycin. pyrimidine and purine bases are eliminated by binding to DNA and producing strand scission. Purpose of Study: To discover how survivin plays a role in hypertrophic scar (HTS) aetiology as well as to measure tissue levels of survivin before and after intralesional bleomycin therapy. In this study, the intralesional bleomycin was administered to 20 patients with HTS, while 20 healthy persons of same age and sex served as a control group (Group B). Real-time polymerase chain reaction was used to measure the serum levels of survivin in all of the participants in the study (RT-PCR). Survivin gene expression was considerably elevated in the HTS group prior to treatment compared to healthy control gene expressions. The HTS group, on the other hand, demonstrated a substantial decrease in survivin gene expression after treatment as compared to the control group and before to treatment. Substantial positive link with scar size and total baseline VSS score was found for survivin gene expression at baseline; however, significant negative correlations were found for improvement. There was a substantial positive link between total VSS score after therapy and survivin, whereas a significant negative correlation with improvement. Survivin did not have any significant associations with any of the other HTS parameters. Using age, gender, smoking, and baseline survivin gene expression as confounders, logistic regression analysis was used to predict the development of HTS. Survivin was believed to be a risk factor for HTS. Age, gender, smoking, duration, previous treatment, and baseline survivin gene expression were all taken into account as potential confounders in a linear regression model used to estimate the severity of HTS (higher VSS score). Survivin gene expression was shown to be an independent risk factor for the severity of HTS (B=6.586, p=0.045) at the beginning of the study. Survivin gene expression may have a role in HTS pathogenesis, according to our results In addition, its level may be used as a predictor of HTS vulnerability and severity on its own.