Imiquimod is the first new generation immunomodulator approved for the treatment of anal and external genital warts. Domestic and international studies have shown that 5% imiquimod cream has good efficacy and low recurrence rate in the treatment of external genital and perianal warts, but with the traditional CO2 laser treatment there are shortcomings such as slow onset of action and longer time for wart removal. We used CO2 laser combined with topical 5% imiquimod cream to treat condyloma acuminata and compared it with CO2 laser alone to observe the efficacy and safety of imiquimod cream in preventing recurrence of condyloma acuminata, and obtained satisfactory results. The wart was removed by cauterizing the lesion and its surrounding 5mm with CO2 laser, and then applying 5% Imiquimod cream externally after the wound healed in 7-10 days. (Week 1, 3, 5 or Week 2, 4, 6) for a period of 12-16 weeks. Imiquimod is a synthetic non-nucleoside isocyclic imidazolinium drug, which has shown strong antiviral and antitumor activities in human and animal in vivo and in vitro tests, mainly through the induction of cytokine expression in a variety of immune-related cells, enhancing the body’s natural and acquired immune response, and inducing the production of interferon (IFN)-α, β, γ and The clearance rate of small warts treated with topical imiquimod alone for more than 8 weeks was 40%- 83%, and the recurrence rate was reduced to 13%-19%. However, for larger warts, more warts, and obvious keratinization, the clearance time is longer and the efficacy is poorer. We first used CO2 laser to remove the lesions and then treated with topical imiquimod cream, the recurrence rate was only 19.05%, which obviously improved the efficacy. In this observation, most patients showed mild to moderate local inflammatory reactions, manifested as erythema, edema, erosion, superficial ulceration, pruritus, burning sensation, and pain, which resolved on their own with symptomatic treatment or suspension of medication for 3-5 days. Therefore, removal of warts with CO2 laser followed by topical imiquimod cream to prevent recurrence of lesions is the ideal treatment for warts.