Introduction: Post burns hypertrophic scar is the most serious problem with the burned patient. There are different physical therapy modalities used in the rehabilitation of post-burn scars as pressure therapy, splinting stretching exercises, mechanical massage, and shock wave therapy. Aim: our study was applied to detect the efficacy of combining treatment vacuum massage and shockwave on the post-burn scar. Methods: Forty patients with post-burn scars, age 20-40 years old randomly divided into 2 groups. study group (group A) received manual physical therapy program in addition to combining therapy of shockwave and vacuum massage 3 times per week for 4 weeks, control group (group B) received manual physical therapy program) plus shockwave therapy, 3 times per week for 4 weeks. Results: Skin thickness and VSS decreased significantly in both groups after treatment compared with before treatment but the percent of decreasing of skin thickness and VSS in group A (44.25 and 46.45% respectively) was more than in group B (23.98 and 29.41% respectively). Conclusion: Shock wave treatment has a positive effect on the post-burn scar treatment but the positivity increase if combined with vacuum therapy.