Background: Keloids are benign fibrous dermal tumors originating from skin injury after surgery, piercing or others wounds. Materials and Methods: Sixty-two patients with keloids were treated postoperatively using orthovoltage irradiation. The total dose delivered was 12 Gy in three consecutive days, 4Gy per fraction. Treatment started 24 h after surgery. The median follow-up was 44.5 months. Results: Grade 1 erythema was observed in 48% of patients (30/62) 20/62 patients (32%) showed telangiectasia and altered skin pigmentation as late toxicities. In 10/62 (16%) a clinical relapse was observed. Conclusion: The postoperative orthovoltage radiotherapy for keloids is a valid and tolerated method that reduces the risk of recurrence. Aims: evaluate the role of post-operative superficial orthovoltage radiotherapy in the management of keloids.