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Background Micro-focused ultrasound (MFU) has developed as an effective, noninvasive, skin-tightening method. However, certain factors have limited its replacement of invasive surgical procedures, including a relative lack of efficacy, persistence, and reliability. The purpose of this study was to evaluate the efficacy and safety of MFU for noninvasive skin tightening and to determine how long the skin tightening can be maintained. Methods Between October 2013 and November 2014, 41 patients with sagging and laxity of the facial skin were treated with MFU. The treatment was performed following the manufacturer's recommended protocol that called for 300 treatment lines. We evaluated the patients using an automatic skin diagnosis system at pretreatment, and 2 and 4 months after treatment. Results Of the 41 patients treated using MFU, 3 patients were lost to follow-up for non-study-related reasons. In our study, 38 patients (1 male and 37 female) were evaluated and ranged in age from 37 to 52 years. The median skin grade scores were 5 at pretreatment, 3 at 2 months posttreatment and 3 at 4 months posttreatment. After comparing pretreatment and 2 months posttreatment, pretreatment and 4 months posttreatment, and both 2 and 4 months posttreatment, there were statistically significant differences (P<0.01). Conclusions This study suggests that the aging face, with wrinkling and sagging, can be improved using MFU, while minimizing injury to the epidermis and dermis.