Abstract: Objective To observe the therapeutic effect of radiofrequency ablation under operating microscope on facial pigmented nevi. Methods Forty-nine patients aged 15-69 years(15 males and 34 females) with 175 facial pigmented nevi who visited the Outpatient Department in our hospital from January 2009 to March 2011 were included in this study.The diameter was <1.5mm in 51,1.6-2.5mm in 78,2.6-3.5mm in 26,3.6-4.5mm in 4,6mm in 2 and 7mm in 2 patients respectively while that of conjunctival nevi was 2mm×1.5mm and 3mm×4 mm×4mm in 2 patients respectively.The patients were treated once by radiofrequency ablation and followed up for 6-24 months to observe their stable therapeutic effect. Results Of the 175 facial pigmented nevi,124(71%)were cured with its size reduced to >50% in 37(21%),10%-50% in 7(4%) and no improvement in 7(4%).No bleeding occurred during treatment with mild injury.A protective layer was formed with no infection after treatment.Small scar,depressed scar,imprint,pigmentation and mild de-pigmentation with a diameter of 7mm were observed in 3,1,6,2 and 1 patients respectively during the follow-up. Conclusion The curative rate of XL-radiofrequency ablation under operating microscope for facial pigmented nevi is high with a low incidence of scar formation and less times of treatment.