Background Triamcinolone acetonide intralesional injection (TAIL) has been used for the treatment of keloids, but only with limited success. Interferon-alpha (IFN-alpha) is the most widely used IFN, and has mainly antiviral, antiproliferative, and antitumoral functions. A few studies have evaluated the efficacy of IFN-alpha 2b in controlled trials for the treatment of keloids. Objective To compare the efficacy and side-effects of keloid treatment using IFN-alpha 2b and TAIL, and TAIL only. Methods Twenty lesions (combined TAIL + IFN-alpha 2b group) and 20 control lesions (TAIL-only group) were studied in 19 patients (14 women and five men). The age range was 7-51 years (mean age, 24.6 years). Both groups were treated with TAIL every 2 weeks. The combined TAIL + IFN-alpha 2b group was treated with intralesional injection of IFN-alpha 2b, twice a week. Lesion measurements were made using thread, glue, and alginate. Results Statistically significant decreases in depth (81.6%, P = 0.005) and volume (86.6%, P = 0.002) were observed in lesions of the combined TAIL + IFN-alpha 2b group. In the TAIL-only group, the decreases in depth (66.0%, P = 0.281) and volume (73.4%, P = 0.245) were less statistically significant. The main side-effects were fever and flu-like symptoms, mild pain, and inflammation at the injection site. Conclusions Intralesional IFN-alpha 2b is an effective and safe treatment for keloids. Although the recurrence rate is as yet unknown, more than 80% improvement was noted in the majority of cases. Hence, adjuvant intralesional IFN-alpha 2b should be considered, particularly for patients who have a history of failed corticosteroid injections.