The aim of this study was to evaluate the rapidly growing use of Nd:YAG 1064 nm lasers for laser lipolysis, and to compare this wavelength with other wavelengths used for laser lipolysis in terms of safety and efficacy. The wavelength dependence of laser lipolysis was simulated using a Monte Carlo computer simulation. The results show that the Nd:YAG 1064 nm wavelength is the optimal wavelength for laser lipolysis in terms of safety and efficacy. Compared with other wavelengths, the 1064 nm wavelength exhibits the largest directly heated volume of subcutaneous tissue and has the smallest undesirable thermal effect on neighboring dermal tissue. The pulsed QCW mode of operation of the Nd:YAG laser also has a significantly higher ability to coagulate blood vessels when compared to continuous wave (CW) diode lasers. The high performance and versatility of the latest technology Nd:YAG 1064 nm laser lipolysis systems, combined with their optimal safety and efficacy, make these lasers the medical devices of choice.