Twenty-one consecutive patients with osteoid osteoma treated with computed tomography-guided radiofrequency ablation, after failed conservative treatment, were retrospectively reviewed. The diagnosis was based on typical clinical and imaging features. Radiofrequency ablation of osteoid osteomas was undertaken by heating the tip of the electrode to 90 degrees C for three sessions of 2 min each. Follow-up evaluation included clinical examination and questionnaire, and radiographic evaluation was conducted on the first month, 12th month, and at the latest examination. Within the. rst 24 h post-procedure, pain was improved in all patients. Seven patients had pain relief within the. rst 3 days, 11 patients within the. rst week, and 3 patients within 2 weeks post-procedure. A month after the procedure, no patient had difficulty regarding self-care and daily activities. At a mean follow-up of 29 months (range 12 -60 months), early or late complications and signs of local recurrence were not observed.