The use of erbium,chromium:yttrium-scandium-allium-garnet (Er,Cr:YSGG) laser with a wavelength of 2.78 μm for hard bone tissue ablation was evaluated. The surface morphology and microstructure changes of bone tissue treated with Er,Cr:YSGG were analyzed as compared to those treated with diamond drill. The influence of fluence on ablation rate and ablation efficiency as well as microstructure was also examined. The results show that Er,Cr:YSGG laser can perform bone perforation that is more fine and presented a lot of unique advantages compared to traditional methods. An approximately linear relationship was observed between the ablation rate/ablation efficiency and radiant exposure. Increasing the radiant exposure irradiated on bone tissue will produce stronger thermal injury around the crater and result in microstructure changing.