Background: Acne scarring is a common dermatologic condition that causes problems cosmetically and psychologically. Dermaroller is an effective method for treating acne scars. It is presumed to promote removal of damaged collagen growth and induce more collagen immediately under the epidermis. Chemical Reconstruction of Skin Scars (CROSS) method is focal application of full concentration trichloroacetic acid (TCA) to atrophic acne scars, used to maximize its effects and overcome its complications. It has the advantage of reconstructing acne scars by increasing dermal thickening and collagen production.Objective: The purpose of this study was to compare the safety and efficacy of Dermaroller and high concentration TCA CROSS method as different therapeutic modalities for the treatment of atrophic acne scars.Patients and Methods: The study was conducted on 30 patients; only 27 of them completed the course of treatment. Patients were randomly equally divided into 2 groups; patients in group 1 were subjected to 4 sessions (with 6 weeks apart) of Dermaroller, and patients in group 2 were subjected to 4 sessions (with 6 weeks apart) of full strength TCA CROSS technique.Results: Acne scarring improved in 100% of patients. Scar severity scores improved by a mean of 68.28 % (P value<0.001) in group 1 and a mean of 75.30 % (P value <0.001) in group 2. The degree of improvement was not statistically significant when comparing both groups (P value 0.47).Conclusion: Both Dermaroller and high concenteration TCA CROSS technique are effective in treatment of atrophic acne scars and gave comparably close results.