Introduction The objective was to investigate the clinical effect of an adjustable pulse width Pulsed Dye Laser (PDL) vs an adjustable pulse width PDL combined with fractional CO2 laser in treating immature red hypertrophic scars. Methods Fifty-six patients (56 sites)were randomly divided into a treatment group and control group. The control group was treated with the 595 nm PDL at a fluence of 7-15J/cm2 and pulse widths of 1.5-3 ms, 7 mm spot size. The treatment group was treated with a fractional CO2 laser (UltraPulse CO2: Deep FX, Energy: 30 50 mJ, Frequency: 300 Hz, Density 5%, Scan Shape, and Spot Size were decided by shape and area of scar) after utilizing the 595 nm adjustable pulse width PDL (Fluence: 7-15J/cm2, Pulse widths: 1.5-3 ms, Spot size: 7 mm). MEBT/MEBO, previously described as a post-treatment wound ointment, was used after laser treatment. The scars of the treatment group and the control group were evaluated for changes in pigment, height, vascularity, and pliability using the Vancouver Scar Scale (VSS) after two laser treatments. Results The total VSS score, as well as the score for melanin, height, vascularity, pliability in both groups, showed an obvious decrease following the treatments. There were statistically significant differences between before treatment and after treatment (P < .05); however, the total score of the VSS, and score of the melanin, height, vascularity, and pliability in the control group decreased more than that of treatment group, and there was a statistically significant difference (P < .05). Conclusions The 595 nm adjustable pulse width PDL combined with the fractional CO2 fractional laser appears to have a beneficial clinical effect on fresh red hypertrophic scars, with no severe adverse reactions seen.