Osteoid osteoma is a benign tumor formed of osteoid and woven bone surrounded by a halo of reactive bone. This lesion is most common in young patients. The classical surgical treatment for this tumor include curettage, en bloc resection and wide resection and have been applied for many years, the success of classical surgery has been reported as 88-100%. Minimally invasive method which is represented by radiofrequency ablation has been proven to be a safe and effective method. The objective of this study is to evaluate the clinical success of radiofrequency ablation in treatment of osteoid osteoma at various sites (except spine and pelvis) and comparing the results with open surgical curettage. Thirteen patients with Osteoid osteoma (7 female and 6 male). Their ages were between 7-36 years, the osteoid osteoma localized in extremities, (six were treated by x- ray guided radiofrequency ablation and seven treated by open surgical curettage) at Al-Sader medical city and the Iraqi specialized center in Al-Najaf city. From June 2018 to August 2019 with a follow up period ranged from 6-12 months. Pain severity were evaluated by using visual analogue scale before and after the procedure. The VAS scores for all osteoid osteoma patients treated either with radiofrequency ablation or with surgical excision significantly decreased except for one case treated with radiofrequency ablation in which recurrence had been reported. There was absence of few patients at time of six months follow up visit. There were no significant intraoperative complications, like pathological fracture. In conclusions; surgical curettage is potentially an effective method without any recurrence. RFA is a safe and effective minimally invasive treatment.