Keloids and hypertrophic scars are fibroproliferative disorders of the skin that result from abnormal healing of injured or irritated skin. Multiple studies suggest that genetic, systemic, and local factors may contribute to the development and/or growth of keloids and hypertrophic scars. Moreover, the severity of scarring is shaped by interactions between these local factors, genetic factors, and systemic factors such as hypertension and sex hormones. To identify risk factors associated with keloid recurrence in keloid patients undergoing surgery with adjuvant radiation therapy in a single institution in Taiwan. We retrospectively collected keloid patients who underwent keloid excision with adjuvant radiation therapy during September 2018 to December 2022 in Chang Gung Memorial Hospital, Keelung, Taiwan. Keloid recurrence occurred in 37 patients (20.6 %). In recurrence group, keloids located more at high-recurrence area, namely anterior chest, shoulder-scapular, suprapubic, and lower jaw. Also, the causes of keloids in this group were significantly more likely to be unknown or minute. In multivariate analysis, no independent risk factor was identified. There is no independent risk factor was identified in this study. Further study would design to investigate potential risk factors.