Background: Striae distensae (SD) are visible linear scars in areas of dermal damage due to excessive stretching of the skin. Striae can cause cosmetic morbidity and psychological distress, particularly in women. In spite of several advances, no definitive treatment has emerged. Aim: The aim of this study was to evaluate the efficacy of microneedling versus cryoroller liquid nitrogen therapy in the management of striae distensae both clinically and histopathologically. Methodology: Striae of all 27 patients were treated with needling and cryoroller liquid nitrogen therapy on two different sides of each patient. Digital photography and skin biopsy were done to assess clinical and histopathological improvement. Results: On the evaluation of clinical response, poor clinical response (=25%) was seen in 92.6% (n = 25) of patients on the dermaroller side, followed by moderate clinical response and on the cryoroller side, poor clinical response was seen in all 27 patients. Comparing the two sides, on the dermaroller side, 77.8% (n = 21) were satisfied and on the cryoroller side, 55.6% (n = 15) of the patients were slightly satisfied and 29.6% (n = 8) were satisfied. The histopathological improvement was almost similar on both dermaroller and cryoroller sides. Conclusion: Both microneedling with dermaroller and liquid nitrogen cryoroller were found to be safe and partially effective methods to treat striae. Patients were more satisfied with microneedling than cryoroller.