Background: Skin laser therapy can produce a surgical smoke that is known to be harmful. However, patient-based study during laser therapy for skin rejuvenation has not been adequately evaluated yet. Objectives: To determine the chemical composition of a surgical smoke produced during an ablative fractional CO2 laser for skin rejuvenation. Methods: A total of 22 smoke samples during the treatment of an ablative fractional CO2 laser for facial rejuvenation and 2 control samples were collected from a continuous irrigation suction system attached to a Tenaxabsorber at a 0.05L/in flow rate. The gases were qualitatively analyzed by gas chromatography-mass spectrometry equipped with a purge and trap sample injector. Results: The total of 9 toxic and carcinogenic chemical components of surgical smoke including 1,4-dioxane, 1-dodecanol, 1H-indole, 1-octadecanol, 2-propenenitrile, 4- methylbenzenamine, 1-methylenthyl benzene, chloroform and tetradecane were produced during laser therapy which were not detected in control samples. These materials should have to be cautious, because it might lead to skin and eye irritation, and pulmonary damage by inhalation due to its various toxicities. Conclusion: The surgical smoke produced by an ablative fractional CO2 laser contains potentially harmful chemical compounds; therefore, filter mask in higher quality and smoke evacuation devices are needed even in the skin rejuvenation laser for safety.