Background. Widespread unilateral nevus spilus causes important cosmetic and psychological disturbances, and only a few therapeutic options can guarantee good functional and cosmetic results.

Objective. To evaluate the clinical response of a patient with widespread segmental nevus spilus to Q-switched (QS) alexandrite laser.

Methods. The treatment was QS alexandrite laser (755 nm, 100 nsec) with a mean fluence of 7.28 ± 0.37 J/cm2 using a single-impact technique at 10 ± 8.47-week intervals.

Results. Fifty percent clearance of the facial portion of the lesion was observed after 16 treatment sessions with QS alexandrite laser.

Conclusion. QS alexandrite laser is suitable for removal of widespread segmental nevus spilus.