Aim: To provide a quantitative assessment of the clinical effectiveness of the high-energy Nd:YAG laser therapy versa traditional pharmacotherapy in patients with papulopustular rosacea. Materials and Methods: The study included 40 patients with clinically diagnosed papulopustular rosacea. Participants were divided into two subgroups: one received standard pharmacotherapy with systemic retinoids, and the other underwent fractional Nd:YAG 1064 nm laser treatment. Clinical outcomes were assessed using digital image analysis (ImageJ software), with erythema quantified in pixel units and relative facial area involvement. Statistical evaluation was performed with Student’s t-test, considering p < 0.05 as significant Results: Both treatment modalities demonstrated clinical improvement; however, outcomes were more pronounced in the laser-treated group. Traditional pharmacotherapy achieved a 22% reduction in erythema area, while Nd:YAG laser therapy resulted in a 79% reduction. The proportion of erythematous facial area decreased from 24.4% to 16.7% in the pharmacotherapy group and from 27.6% to 5.7% in the laser group. No systemic or local adverse effects were reported. Conclusions: Nd:YAG FRAC3® laser therapy demonstrated superior efficacy over pharmacotherapy in reducing erythema and inflammatory manifestations in papulopustular rosacea. These findings support its role as an effective and safe alternative or adjunct to standard pharmacological management.