Background: Surgical excision offibroglandular tissue and liposuction offatty element are the standard now in treatment of grade II gynecomastia.  However, the combined use of laser assisted liposuction and endoscopic  surgical excision have not been studied before. Patients  and  methods:  Thirty  male  patients  with grade !fa  and  Jib were  included.  15 patients underwent  laser  assisted liposuction  followed by endoscopic  excision  of glandular tissues (Group I), and 15 patients underwent  conventional (vacuum assisted) liposuction and endoscopic surgical excision (group II). Results: Patients of group I showed good to excellent outcome with mild edema, indurations, and ecchymosis. Group II patients showed also overall satisfactory results but with moderate to severe edema, ecchymosis, and hematomas. Conclusion: Endoscopic surgical excision of grade!!gynecomastia combined with traditional or laser assisted liposuction can achieve satisfactory results. However, the use of laser assisted liposuction offers additional advantages such as; intraoperative (less bleeding, less operative time) or postoperative either immediately (less pain, indurations,  ecchymosis, and edema) or late as improved skin tightness.