Background Scars are known to negatively impact patients' quality of life or even disable them. A broad spectrum of different scar treatments is used in clinical practice. Platelet-rich plasma (PRP) and microneedling are promising treatments that enhance tissue regeneration. The aim of this study was to evaluate the safety, clinical effects, and patients' experience of a combination treatment consisting of a series of PRP plus microneedling. Methods One hundred seven patients with scars, with various etiology and scar age, were included in our study. PRP had been prepared using the ACP double syringe system and was injected with high pressure into the dermis of the affected tissue, using the U225 meso injector as an injection and microneedling device. This treatment was applied three times at four-week intervals. On the days of treatment and at the 4-week follow-up, patient records were collected and clinical investigations and interviews were performed to assess clinical effects, adverse effects, and patient's experience. Results The results of this retrospective study indicate that 23 patients (21.5%) reported softer and more elastic scar tissue, 8 patients (7.5%) experienced improved mobility and functionality, 6 patients (5.6%) showed an overall healthier skin appearance, and 8 (7.5%) patients observed an improvement in color. Adverse effects reported were mild and only temporary. Twenty-three (21.5%) patients felt stressed before the treatment, and 12 patients (11.2%) reported tenderness during the first treatment of which two rated it as mildly painful. After the first treatment, two patients (1.9%) reported transient itchiness. Serious adverse effects did not occur. Conclusions PRP plus microneedling can enhance the pliability, mobility, and color of different scar types and scar ages. Overall, the treatment was easily feasible, well-tolerated and safe. Therefore, it can be considered a promising new treatment modality for scar management.