Background: Scaling and root-planing (SRP) remains the foundational non-surgical treatment for periodontitis, but residual pockets, incomplete bacterial removal and patient discomfort motivate adjunctive approaches. Laser-assisted periodontal therapy (LAPT) — including Er:YAG, diode, Nd:YAG, CO₂, LANAP and photodynamic therapy (PDT) — is proposed to improve microbial decontamination, tissue management and healing. Objective: To systematically review clinical, microbiological and patient-centred outcomes comparing LAPT (monotherapy or adjunctive) with conventional SRP in adult periodontitis patients, emphasizing studies from 2018–2025. Methods: Searches of PubMed/MEDLINE, Cochrane Central and open access journals (through Oct 2025) identified randomized controlled trials (RCTs), controlled clinical trials and systematic reviews comparing any LAPT versus SRP. Primary outcomes: probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain. Secondary outcomes: bleeding on probing (BOP), plaque/gingival indices, microbiological/inflammatory markers, patient-reported outcomes and adverse events. Data were extracted by two reviewers and synthesized qualitatively due to heterogeneity in laser types and protocols. Results: Thirteen RCTs/controlled trials and multiple systematic reviews/meta-analyses were identified. Adjunctive laser therapy (particularly Er:YAG or diode lasers used in well-specified protocols) often produced modest additional short-term improvements in PPD, CAL and BOP versus SRP alone; effect sizes were commonly <1 mm and declined over time in many studies. Photodynamic therapy (PDT) adjuncts and some LANAP/ Nd:YAG protocols show promising reductions in pathogens and early clinical markers [7,17,22]. Evidence quality is variable; heterogeneity of laser parameters, operator skill and follow-up durations limit generalizability. Conclusions: LAPT can provide modest incremental clinical benefits as an adjunct to SRP in selected protocols and patient subsets (e.g., residual deep pockets), especially in the short term. There is insufficient robust evidence to support routine replacement of SRP by lasers. Standardized laser protocols, larger multicentre RCTs and ≥12-month follow-up studies (including cost-effectiveness) are needed.