Objective To observe and analyze the adverse reactions and related risk factors of superficial X-ray radiotherapy after keloid surgery. Methods A retrospective analysis was conducted on patients who received superficial Xray radiotherapy after keloid surgery from November 2019 to October 2020. General information of the patients was collected. Through the follow-up records at 1 and 6 months after the surgery， local adverse reactions were evaluated， the incidence of adverse reactions was statistically analyzed， and the risk factors related to the incidence of common adverse reactions were analyzed. Results A total of 76 patients were collected， including 96 keloids. The most common adverse reaction was pigmentation （80.2%）， followed by telangiectasia （16.7%）. The location of keloids is a risk factor for the incidence and severity of pigmentation， while telangiectasia has no significant correlation with various factors. Conclusion Pigmentation is the most common adverse reaction associated with superficial X-ray radiotherapy after keloid surgery， and its incidence and severity may vary depending on the treatment location. Adequate communication with patients can significantly improve treatment satisfaction.

Keloid, Surgery, Superficial X-ray, Adverse reaction, Relation risk factors