Background: For gynecomastia, many treatment options are available, but surgery modalities with or without liposuction and laser-assisted lipolysis (LAL) are the mainstream. A novel Nd:YAG device has recently been developed that emits energy at a wavelength of 1444 nm. Objectives: To evaluate the effectiveness and safety of 1444-nm Nd:YAG LAL for the treatment of gynecomastia. Methods: We performed a pilot study in 13 patients who were treated by LAL using the novel 1444-nm Nd:YAG laser for the treatment of gynecomastia Results: Twelve weeks after treatment, most of the patients (84.5%) were scored to be the improvement more than 50%.The side effects (pain, edema, numbness, and ecchymosis) were minimal and disappeared shortly after first manifestation. Conclusion: Our study demonstrated that the 1444-nm Nd:YAG LAL reduced the breast size of gynecomastia patients without serious complications.