Background. Keloids are benign fibrous dermal tumors originating from skin injury after surgery, piercing or others wounds. Aims. To evaluate the role of post-operative superficial orthovoltage radiotherapy in the management of keloids. 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 telangiectasias and altered skin pigmentation as late toxicities. In 10/62 (16%) a clinical relapse was observed. Conclusions. The postoperative orthovoltage radiotherapy for keloids is a valid and tolerated method that reduces the risk of recurrence.