The efficacy of carbon dioxide laser excision as a primary modality for the treatment of keloids was evaluated. This retrospective study focuses on 31 patients with one or more keloids, 23 of whom were available for follow-up after carbon dioxide laser excision. The patients' ages ranged from 5 to 72 years. There were 16 females and 7 males. One patient was Caucasian, 22 patients were non-Caucasian, and there were no Asians. The keloids that were excised ranged in size from 1 to 30 cm in greatest diameter. One patient had no recurrence of her keloid after carbon dioxide laser excision, 9 patients required steroids to suppress recurrences, and 13 patients were considered failures. Reasons for the failure of this modality, as well as speculation regarding the future of this procedure, are discussed.