Background and Objectives Outcomes analysis of laser treatment for port‐wine stains (PWS) has been hampered by the lack of an objective measure of surface area and volume; moreover, treatment success is often gauged by clinician subjective assessment. Three‐dimensional (3D) surface imaging has been applied in several medical disciplines to quantify surface changes, with promising results. We hypothesized that 3D surface imaging could be used to objectively measure changes in area and volume of PWS following laser treatment. Study Design/Materials and Methods We performed a retrospective review of consecutive patients with PWS treated over a 20‐month time period. Area and volume of the lesions were measured using 3dMD photogrammetric software (3dMD; Atlanta, GA) before and after a series of sequential pulsed dye laser and/or alexandrite laser treatments. Results Fifty‐five patients with 59 PWS were included in the study. The initial average measured area was 45.6 cm2; final average measured area decreased to 34.6 cm2 (P < 0.001). The average volume change was 1.20 ml for all PWS included in the study and 1.90 ml for lesions that received at least five laser treatments within the study period. Conclusion Three‐dimensional photography demonstrated area and volume changes in patients with PWS after laser treatments. Future studies to determine if statistically significant changes correlate with clinically appreciable changes are warranted. Lasers Surg. Med. 45:633–638, 2013. © 2013 Wiley Periodicals, Inc.