Cryosurgery is currently regarded as the treatment of choice for keloids and hypertrophic scars. Four techniques are established or currently under evaluation in this area. The first is cryosurgery as monotherapy. Using this regimen, 241 of 356 patients (68%) with keloids and 72 of 89 patients with hypertrophic scars (81%), showed a greater than 50% improvement or complete regression (five studies). Using the second technique, cryosurgery with intralesional corticosteroids, significant regression of keloids was found in 119 of 159 patients (75%; four studies). Cryosurgery induces tissue edema and facilitates intralesional injections; however, the combined therapy was not superior (90% greater than 50% reduction of lesional volume) to monotherapy (83.3%) in a study of 40 patients with keloids. The third technique is surgical debulkment prior to cryosurgery without corticosteroids. This regimen is unavoidable in large keloids; however, it can result in recurrences despite its shortterm promising effects. Intralesional cryosurgery, the fourth technique, was developed by modifying the technique by Weshahy and is under evaluation in our department. In addition, histological and immunohistological studies of keloids and keloidal fibroblasts in vitro treated by cryosurgery have detected changes indicating potential rejuvenation of the scars.