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Aim The aim of this study is to study the treatment efficacy of surgical excision of keloids with postoperative high dose-rate (HDR) brachytherapy. Material and methods Between January 2013 and April 2016, 30 patients with 42 keloids were treated with excision of the keloid scar followed by postoperative HDR brachytherapy. Patients were followed-up after 10 days, 3 months and 6 months. Patient satisfaction and recurrence of keloids were measured. Results No patient had symptoms of any recurrence, but 4 had unacceptable results (score of more than 3). Conclusions Surgical excision with postoperative high-dose rate brachytherapy is effective in preventing recurrence of keloid scars. It also provides cosmetically acceptable results. However, the cost involved in such treatment is a hindrance on the Indian subcontinent.