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Background and Design: Various lasers, mainly nanosecond Q-switched (QS), and picosecond lasers, have been successfully used to treat solar lentigines. However, picosecond lasers are expensive, and QS lasers have a higher risk of post-inflammatory hyperpigmentation (PIH) in darker skin types. The aim of our study is to examine retrospectively the efficacy and safety of long-pulsed alexandrite laser in the treatment of solar lentigines, compare our findings to previous studies with nano and pico-second lasers, and evaluate long-term outcomes regarding recurrence. Materials and Methods: We retrospectively analyzed 39 patients with a clinical diagnosis of solar lentigo treated by long pulsed alexandrite laser. Patients' photographs and clinical charts were reviewed in terms of demographic features, areas of treatment, number of sessions, laser settings, recurrence of lesions, Fitzpatrick's skin type, and any side effects observed. Results: The rate of improvement was excellent in 33 (84.6%), moderate in 4 (10.3%), and mild in 2 (5.1%) patients. Seven (17.9%) patients with Fitzpatrick's skin type III and IV developed PIH. Lesion recurrence was observed in 5 patients (12.8%). Mean time to recurrence was 57.98±4.45 months. Conclusion: Our study suggests that long pulsed alexandrite laser is an effective and safe option in the treatment of solar lentigines. [ABSTRACT FROM AUTHOR]