Photodynamic therapy emerged in the 1900s and recently, it has been developed as a novel modality for treating tumors, precancerous lesions, hypertrophic skin diseases, vascular diseases and so on. We aimed to compare the efficacy and adverse effects of surgery combined with photodynamic therapy or triamcinolone acetonide injection for keloid treatment. This self-controlled study included nine patients with keloids. Two keloid sites were selected for each patient: one site received photodynamic therapy (PDT group) and the other site received local triamcinolone acetonide injections (TA group). All the keloids were surgically excised. The Vancouver Scar Scale and pruritus and pain scores were assessed at 3 and 6 months, respectively. At 3 and 6 months postoperatively, the pruritus and pain scores decreased significantly (P < .01) and equally in both groups (P > .05). At 6 months postoperatively, the PDT group showed the following results: complete cure, one patient; significantly effective, four patients; effective, four patients; and ineffective, no patient (efficacy, 100%). The TA group showed the following results: complete cure, one patient; significantly effective, three patients; effective, four patients; and ineffective, one patient (efficacy, 88.9%). Between-group differences were not significant (P > .05). Hyperpigmentation was observed (n = 2) in the experimental group, whereas menstrual disorders (n = 2), local capillary dilation (n = 1) and subcutaneous atrophy (n = 1) were observed in the TA group. Photodynamic therapy and local triamcinolone acetonide are equally Xie Fang, Li Cheng-xin, Qi Jing and Lin Xing-xiao have contributed equally to this work.Qi Jing and Lin Xing-xiao should be considered joint first author.