Traditional treatment of keloids by surgery or surgery combined with other techniques has met with limited success. Successful treatment of sternal keloids by surgical excision and skin grafting, followed by radiation therapy is reported. Eleven patients, ranging in age from 14 to 66 years, were so treated. The groin was used as a donor site in all patients. Postoperative radiotherapy was administered to suture lines only, using three doses of 500 cGy each, such that 1,500 cGy was delivered within 7 to 14 days of surgery. The protocol was followed without variation in all patients. Follow-up ranged from 1 to 24 years. Only 1 patient demonstrated recurrence. Six patients received postoperative, episodic steroid injections for localized itching or nodule formation. None of these patients demonstrated recurrence of their keloids.