Objective: To compare the clinical efficacy and safety of UltraPulse Fractional CO? Laser (UP) alone versus UP combined with Intense Pulsed Light (IPL) for hypertrophic scars after cesarean delivery. Methods: A total of 58 patients with post - cesarean section hypertrophic scars from the Department of Medical Aesthetics, Nanjing Maternal and Child Health Hospital between March 2022 and August 2024 were selected as research subjects.Clinical data of 58 patients (from 78 initially enrolled between March 2022 and August 2024) were analyzed. The control group (31 patients) received UP treatment, while the observation group (27 patients) received UP + IPL treatment. Evaluations included the Vancouver Scar Scale (VSS), Visual Analogue Scale (VAS) for scar itching and pain, and adverse reactions. Results: Baseline VSS and VAS scores were similar between groups (P > 0.05). The observation group showed significantly higher improvements in scar color and vascular distribution scores (P < 0.05), similar improvements in thickness and softness scores (P > 0.05), and higher reductions in VAS scores for itching and pain (P < 0.05). The observation group also had a significantly higher total effective rate (P < 0.05) and more cases of blistering (P < 0.05), with no other significant differences in adverse reactions. Conclusion: Compared to UP alone, UP+IPL significantly improves the vascular distribution, color, itching, and pain of hypertrophic scars after cesarean section, without increasing the incidence of adverse reactions other than blisters.