These two do the same job. Both use magnetic energy to force strong muscle contractions, on the stomach, buttocks and thighs, and neither one removes fat. EmSculpt is the one to pick if you want more choice. It is used on more body areas, it has more published research behind it, and its NEO version adds heat that also reduces fat. If your clinic only owns a CoolTone, that is not a reason to walk out. For muscle alone, the two are close.
Magnetic pulses clench the muscle far harder than you can on purpose.
The NEO version also warms the fat layer above, so it does both in one session.
The muscle tightens and lets go, over and over. Strange rather than painful.
The radiofrequency version feels hot as well, a bit like a warm stone pressed on the skin.
It is the newer and less studied of the two, and it is offered on fewer parts of the body.
Two machines share the name. Plain EmSculpt does muscle only. Only NEO also reduces fat, and it costs more.


Plain EmSculpt and CoolTone are close: Both are muscle-only devices, both take about 30 minutes, both need a course and then top-ups. Choosing between them on results alone is splitting hairs.
EmSculpt NEO is the one that behaves differently: It adds radiofrequency heat, so it reduces fat as well as building muscle. That makes it the option for someone with a soft layer over the muscle.
So ask which machine is in the room: "EmSculpt" on a price list can mean either version, and they are not the same treatment or the same price.
If the answer is plain EmSculpt, you are back to a coin toss: At that point, pick on the clinic, the operator and what the full course costs, because the two devices are doing the same thing to the same muscle.
Both build muscle in one area only: They do nothing for your heart, your stamina or your weight.
Both fade if nothing else changes: Muscle that is not used softens again. The people who keep their result are usually training as well.
Neither one is a weight-loss treatment: If there is a real fat layer over the muscle, deal with that first or the change will not show.
Neither one tightens loose skin: Contractions happen below the skin and do not shrink it.
Neither one repairs separated stomach muscles: If the muscles have parted down the middle, strong contractions do not pull the gap closed. That repair is surgery.
Neither one gives a result you can see on the day: Expect to judge it several weeks after the course, from photos in the same pose and light.
Ask which machine they own, and if it is an EmSculpt, whether it is the NEO.
Ask how many sessions are in the course and what the total costs.
Ask what top-ups cost over a year.
Ask to see photos of the same area on someone with a similar build.