Background: One of these methods is the thread lifting approach using polydiaxonone. Polydioxanone (PDO) threads are thin, non-barbed polymerized threads with a diameter of 0.07 to 0.15 mm. They can be unidirectional or bidirectional and they possess higher strength and flexibility compared to other thread types. The aim of this study was to evaluate the efficacy and safety of polydioxonone thread lifting in lower face (marionette line) rejuvenation. Patients and methods: This study is single non-blinded study, included thirty female patients their ages ranged from 32 to 60 years seeking for lower face rejuvenation attending to the outpatient clinic of Plastic surgery Department, Zagazig University Hospital in the period between September 2023 till March 2024. Patients were treated with three PDO threads in each side of lower face while all patients were followed up at first week, one, three and six months after the procedure. Results: Average scale before the procedure according to the validated grading scale was from 2 to 5 with a mean of 3.37±0.76 and a median 3.50(2.75-4.0). The validated scale range changed to 1 to 3 with a mean of 1.70±0.82 and a median of 1.50(3.0-4.0) immediately following therapy. The global aesthetic improvement scale in group patient, ranged from 20-90% with a mean of 46.33±18.92 and a median 40(20.0-75). There was 10% improvement in three patients, 50% improvement in fifteen patients, 30% improvement in nine patients, and an exceptional 10% improvement in three patients. Conclusion: Polydiaxonone threads are a simple, quick, and successful office technique operation.