Keloids are scars, unique to humans, that grow beyond the boundaries of a cutaneous injury, inflammation, burn, or surgical incision. Although benign, keloids are often aesthetically malignant. The etiology of keloids is uncertain. However, we do know that they occur more often in African-American and Asian than Caucasian patients. There is no one therapeutic modality that either prevents the formation of keloids or treats active or inactive lesions. Consequently, there are many therapeutic options. In this review, an approach to medical and surgical management of keloids is provided, as well as a review of experimental therapeutic modalities.