Infraorbital dark circles are a common cosmetic problem with multiple causative factors and few studies into the different treatment options. To assess the effectiveness and safety of long-pulsed 1,064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser therapy for infraorbital dark circles caused by visible prominent veins. Twenty-six patients with venous infraorbital dark circles were treated with a Nd:YAG laser (fluence, 130-140 J/cm(2) ; spot size, 6 mm) in double-pulse mode (pulse width, 6-10 ms; interpulse interval, 20 ms). Patients were examined 12 months after the final treatment. Results were ranked in five categories based on percentage clearance (5 = 100%, 4 = 75-99%, 3 = 50-74%, 2 = 25-49%, 1 ≤ 25% clearance). Patient satisfaction was ranked on a scale of 1 to 3 (1 = minimal improvement; 3 = completely satisfied), and pain was ranked on a scale of 1 to 10 (1 = mild pain; 10 = severe pain). Twenty-six patients completed the study. Objective improvement scores were 5 in all patients, and all patient satisfaction scores were 3. All patients tolerated the moderate pain (mean score 3.6). Transient erythema was observed in all patients. Long-pulsed 1,064-nm Nd:YAG-laser treatment appears effective and safe for the treatment of venous infraorbital dark circles and selectively removes visible prominent veins. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.