BACKGROUND: Laser-Assisted Lipolysis (LAL) has emerged as a modern advancement in body contouring, offering solutions to limitations of traditional liposuction such as prolonged recovery, increased bruising, and limited skin-tightening effects. By using targeted laser energy to liquefy fat before removal, LAL minimizes tissue trauma, enhances skin retraction, and improves overall aesthetic outcomes. OBJECTIVE: To provide a comprehensive review of the historical evolution, current technological advances, comparative methodologies, limitations, and future directions of LAL in cosmetic surgery. METHODS: A narrative literature review was conducted, incorporating peer-reviewed articles, FDA-cleared devices, and clinical studies. Topics included the historical progression of LAL since its inception in the late 1990s, comparative analyses between LAL and traditional techniques, evaluation of laser wavelengths (e.g., 1064, 1320, 1444, and 1470 nm), and examination of innovations such as dual-wavelength systems, robotic-assisted delivery, AI-guided planning, and radiofrequency-assisted methods. RESULTS: LAL shows clinical advantages including faster recovery times, reduced postoperative pain, and improved skin tightening, especially in small to moderate fat reduction areas. Dual- and multi-wavelength lasers, pulse modulation, and fiber-optic temperature sensing improve precision and safety. Comparative studies show LAL achieves better outcomes than traditional liposuction in certain contexts, particularly for skin appearance and submental fat reduction. However, variability in laser parameters, higher procedural costs, and limitations in autologous fat reuse remain concerns. Research also highlights promising applications of LAL in large-volume fat removal and potential bariatric contexts. CONCLUSION: LAL has evolved into a valuable technique in modern aesthetic surgery. While not a replacement for traditional liposuction in all cases, it offers meaningful benefits as a stand-alone or adjunct procedure. Continued innovations, such as nanotechnology, biodegradable fibers, and AI-assisted planning, may further enhance its effectiveness, precision, and personalization in future body contouring practices. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.