Purpose <p>Phymatous rosacea is a chronic and disfiguring subtype of rosacea, mainly affecting the nose and leading to the development of rhinophyma. This condition manifests with erythema, enlarged pores and increased sebum secretion, progressing to textural alterations and nasal hypertrophy. Ablative CO₂ laser resurfacing has emerged as a preferred approach, offering hemostatic control and favorable cosmetic outcomes. This case series presents our treatment experience with a non-fractional ablative CO₂ laser resurfacing under local anesthesia for severe rhinophyma patients.</p> Methods <p>A Retrospective case series of patients with severe rhinophyma treated with an ablative CO₂ laser between December 2010 and March 2020 in our laser unit. Post-procedure aesthetic outcome was assessed by the treating physician 3 months following treatment and patients were asked to complete a long-term follow-up questionnaire. </p> Results <p>Sixteen patients (15 males) were included, of which 13 patients (81%) had completed the questionnaire on an average of 15 months following treatment (range 2–24 months). Patient satisfaction following treatment was high, with an average satisfaction score of 7.9 out of 10 (range 4–10). Post-procedure aesthetic outcome was rated as very good or excellent in 13 patients (81%, with 75% or greater improvement). Among the 13 patients who completed the questionnaire, 11 (85%) indicated that they would recommend this treatment to others with a similar condition. </p> Conclusion <p>Non-fractional, ablative CO₂ laser resurfacing performed under local anesthesia, has proven to be a safe, effective and well-tolerated treatment for severe rhinophyma, yielding sustainable results and high satisfaction rate.</p>