Radiation therapy following excision for keloids has been shown to decrease the recurrence rate by about 50%. We followed 75 patients with 113 keloids for a mean time of 9.75 years. Seventy-four percent of the lesions involved the earlobe. Superficial X ray therapy was used in 89% of the cases. The most frequent dose schedule was 12 Gy in three fractions over 3 days. The overall control rate was 73%. There was no advantage to starting radiation within 1 day of surgery. Keloids greater than 2 cm in size, those that had previous therapy, and those occurring in men were found to indicate a high likelihood of recurrence. The mean time to recurrence was 12.8 months. There were no complications from this low dose treatment. Radiotherapy following excision is an effective and safe adjuvant treatment for keloids.