Background: Acne vulgaris is the most common cutaneous ailment in the world, affecting up to 80% of teenagers and up to 50% of adults. It is a chronic inflammatory disease of the pilosebaceous unit. The development of acne lesions is heavily influenced by keratinocyte proliferative and inflammatory states, which have been observed to elevate survivin levels. Objective: This study was conducted to assess survivin gene polymorphism and its plasma level in patients with active acne vulgaris and patients with post acne scars with varying severity. Patients and methods: The study included 60 acne patients divided into two groups: 30 patients with active acne lesions and 30 patients with post acne scars; in addition to 30 healthy volunteers who were served as control group selected from Outpatient Clinic, Department of Dermatology, Andrology and STD, Mansoura University Hospitals, Mansoura, for 1 year duration. Results: The levels of serum survivin in both group of patients with active acne and group of patients with post acne scars are significantly higher than that of the control group. There was no statistically significant difference in the serum survivin levels among the patients with different grades of acne. There was a significant increase in the serum survivin level with increased severity of post-acne scars. The distribution of the survivin rs-9904341 & rs-1042489 genotypes among the study's groups did not differ significantly (P > 0.05) for each. Conclusion: It could be concluded that survivin may be used as a diagnostic biomarker in acne vulgaris and as a prognostic tool for post acne scarring severity. Survivin is involved in the pathogenesis of active acne vulgaris and more importantly, the pathogenesis of the development of fibrotic tissue in acne scars.