Solar lentigo is local and benign proliferation of melanocytes at the dermoepidermal junction. The major concern of these lesions is related to cosmetic issues. The aim of this study was to comprise the efficiency and adverse effects of trichloroacetic acid (TCA) 40% versus cryotherapy in treatment of solar lentigo. This is a study of 68 individuals who suffered from solar lentigines on their hands, one side treated with cryotherapy and the other side with TCA 40% randomly. This treatment was repeated after one month. Photographs of the hands were taken prior to and 2 months following the treatment, and degree of improvement (lightening) of lesions and the resulted adverse effects were collected. The results demonstrated that cryosurgery was more likely to produce lightening of the lentigines than TCA 40% solution, but this difference was not significant (P=.32). Cryosurgery was more painful and took longer to heal. Although cryosurgery had better results than TCA 40% in lower Fitzpatrick skin types, the difference was not significant.