Rosacea presents as transient or persistent erythema, papules, pustules, flushing, and telangiectasia on the middle of the face, which has some clinical similarity with actinic keratosis (AK). These two conditions can coexist in the same patient. Dermoscopy and reflectance confocal microscopy (RCM) could be useful methods for diagnosis and monitoring treatment e±cacy. Novel intense pulsed light-photodynamic therapy (IPL-PDT) may have better tolerance and curative effect than traditional red-light 5-aminolevulinic acid photodynamic therapy (ALAPDT). Herein, we present a case of facial AKs concomitant with rosacea where combination therapy of novel IPL-PDT and oral minocycline was effective in that AK lesions were eliminated and the patient's facial erythema and telangiectasia were significantly improved.