Surgical scars are major post-surgical complications that cause significant psychological and physical consequences, compromise the quality of life and need intensive intervention. Objective: The purpose of this study was to compare the effect of hydrocortisone iontophoresis and hydrocortisone phonophoresis on the treatment of surgical scar and overall scar appearance. Patients and methods: Sixty patients of both sexes (18 males and 42 females) underwent surgery, and had surgical hypertrophic scar took part in this study. Their ages ranged from 20-35 years and they were recruited from Surgical Department-Mansoura Health Insurance Hospital and Horus University in Egypt. Patients were randomized into three groups of equal number (20 patients for each group): Group A: (Iontophoresis group): They received iontophoresis application of hydrocortisone 1%. Group B: (Phonophoresis group): They received phonophoresis application of hydrocortisone 1%. Group C: (Control group). All patients in all groups received their medical treatment (Polydimethylsiloxane cream [twice daily] and Diclofenac Potassium ampoules [once daily]) as well as their conventional physiotherapy treatment (ultrasound and deep friction massage). All outcome measures were measured for all patients before and after 12 weeks of treatment application through tonometer (for measuring pressure load) and Modified Vancouver scar assessment scale (VSS) (for measuring four skin characters including height, pliability, vascularity and pigmentation). Results: Post treatment, the one-way ANOVA test found that there was a highly significant improvement in pressure load and overall scores of modified Vancouver scar scale (VSS) in both iontophoresis and phonophoresis groups compared with control group as P-value < 0.001. Conclusion: Appropriate application of either hydrocortisone iontophoresis or hydrocortisone phonophoresis can induce a significant improvement on height, pliability, vascularity and pigmentation of post-surgical scar