Methods and apparatuses for reducing roughness using integrated atomic layer deposition (ALD) and etch processes are described herein. In some implementations, after a mask is provided on a substrate, methods include depositing a conformal layer on the mask by ALD to reduce roughness and etching a layer underlying the mask to form patterned features having a reduced roughness. In some implementations, after a substrate is etched to a first depth to form features at the first depth in the substrate, methods include depositing a conformal layer by ALD on sidewalls of the features to protect sidewalls and reduce roughness during a subsequent etch process. The ALD and etch processes may be performed in a plasma chamber.