Keloids are disfiguring deformities that occur after trauma or wounding of the skin, most commonly among blacks. The case presented here is unusual because of the number of keloids and the massive size of one. The patient underwent full surgical excision together with intraoperative and postoperative steroid injections with good cosmetic results. Various causes of keloids are reviewed as are the histopathologic differences between hypertrophic scars and keloids. Alternative surgical and nonsurgical treatment techniques are examined.