Tuberous sclerosis (TS) is a genodermatosis characterized by facial angiofibromas (FAs). These tumours cause aesthetic disfigurement and obstruction of vision, and haemorrhage when traumatized, which can lead to emotional distress and relationship difficulties. We report the case of a 35-year-old patient with extensive TS-associated FAs that were treated with an ultrapulse carbon dioxide laser (UPCDL). UPCDL laser seems to be a easy, useful and convenient tool for the treatment of nodular FAs, which provides good aesthetic results, and a positive response from patients, who report high levels of satisfaction with the results. Minimal recurrence of the tumours occurred during long-term follow-up, and these were successfully treated with UPCDL. It is not yet possible to correct the genetic alterations underlying TS, but UPCDL treatment is a convenient tool to improve the facial appearance of patients with severe FAs.