Background: Nd:YAG laser is an important therapeutic modality in dermatology, venereology, and aesthetics due to its precision, effectiveness, deep tissue penetration, and favorable cosmetic outcomes. However, comprehensive data regarding patient demographics and treatment indications for Nd:YAG laser therapy in Indonesia, particularly in tertiary referral institutions, remain highly limited.Objective: To determine the characteristics of patients undergoing Nd:YAG laser therapy at the dermatology and venereology outpatient clinic of Dr. Moewardi General Hospital, Surakarta, for the period of 2016–2025. Subject and Method: A retrospective descriptive study was conducted by analyzing secondary data from the medical records of patients who underwent Nd:YAG laser therapy. The variables examined included demographic characteristics, clinical characteristics such as diagnosis and lesion size, as well as the intensity or number of treatment sessions. Results: A total of 172 patients underwent Nd:YAG laser procedures. Female patients (58.14%) predominated over males (41.86%). The most frequent diagnoses were nevus of Ota (18.02%), tattoo removal (8.72%), and melanocytic nevus (8.14%). Most patients required only 1–2 treatment sessions (58.72%), while 3.49% of patients required more than 15 therapy sessions Conclusion: Nd:YAG laser therapy at Dr. Moewardi General Hospital is more frequently used for congenital dermal pigmentary disorders (melanocytosis) such as nevus of Ota compared to classic global indications like sociocultural tattoo removal. This difference emphasizes that laser practice is not only determined by global trends but is also strongly influenced by local epidemiology, modality availability, and clinician preferences.