Background: Although it can last into maturity, acne vulgaris is a common skin ailment that primarily affects people throughout adolescence. The present study compared red light alone and MAL-PDT in patients with acne vulgaris. Materials & Methods: 76 cases of acne vulgaris of both genderswere divided into 2 groups of 38 each. In group I, patients received red light alone and in group II, MAL-PDT treatment at baseline and after 2 weeks, 4 weeks and 8 weeks.Measurements of inflammatory and non-inflammatory lesions, as well as the severity grade of acne, were made at baseline and at each follow-up appointment. A six-point scoring system was used to assess the severity of acne. Results: Group I had 20 males and 18 females and group II had 23 males and 15 females.Acne severity grade I was seen in 1 and 1, grade II in 20 and 2, grade III in 16 and 30 and grade IV in 1 and 5 patients in group I and II respectively. The difference was significant (P< 0.05). Inflammatory lesions in group I at baseline, 2 weeks, 4 weeks and 8 weeks was 42%, 13%, 12%and 5% respectively. In group II was 54%, 10%, 3%and 1% respectively. Non- inflammatory lesions in group I was 28%, 20%, 14% and 8% respectively. In group II was 46%, 18%, 11% and 2% respectively. The difference was significant (P< 0.05). Grade 0-I in group I at baseline, 2 weeks, 4 weeks and 8 weeks was 5%, 21%, 57%and 79% respectively. In group II was 25%, 53%, 74%and 100% respectively. Grade II- IV in group I at baseline, 2 weeks, 4 weeks and 8 weeks was 45%, 36%, 20%and 5% respectively. In group II was 39%, 28%, 2%and 0% respectively.The difference was significant (P< 0.05). Conclusion: Inflammatory and non-inflammatory lesions benefit greatly from red light MAL-PDT as well as red light alone. However, red light MAL-PDT shows a faster onset of activity and a higher reactivity than red light alone.