<p>Despite being available for more than four decades, laser treatments in proctology are still considered to be particularly modern and are often requested by patients. The procedures are minimally invasive, virtually painless and have a&#xa0;short convalescence time. The disadvantages include the high technical effort, associated poorer availability and higher direct costs compared to conventional methods. The consistently limited evidence, especially with regard to long-term results, has meant that these methods have hardly been considered in the guidelines to date. In addition to the basics of laser therapy, this article presents the practical applications of the laser in HPV-associated lesions, hemorrhoids, anal fistulas and pilonidal sinuses, while considering the guidelines. This provides the proctologist with an overview of the various procedures in practice and the opportunity to provide their patients with comprehensive advice taking laser therapy into account.</p>